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Published online: 2023-09-12

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Right ventricle to pulmonary artery coupling as a predictor of perioperative outcome in patients with secondary mitral valve insufficiency

Jolanta Rzucidło-Resil1, Karolina Golińska-Grzybała1, Barbara Szlósarczyk2, Paweł Rostoff23, Andrzej Gackowski123, Grzegorz Gajos23, Bogusław Kapelak43, Jarosław Stoliński45
Pubmed: 37772356

Abstract

Background: The aim of the study was to assess some parameters of right ventricle (RV) function as
predictors of short-term mortality in patients with severe secondary mitral regurgitation (SMR) after
mitral valve surgery.
Methods: We conducted a retrospective analysis of 112 consecutive patients with severe SMR who
had undergone mitral valve repair or replacement with or without concomitant coronary artery bypass
surgery. We assessed RV to pulmonary artery coupling by calculating the ratio of tricuspid annular
plane systolic excursion (TAPSE) to non-invasively estimated RV systolic pressure (RVSP). The study
endpoint was 30 days post-procedural mortality.
Results: Overall, the 30-day mortality was 6%. TAPSE/RVSP ratio < 0.42 mm/mmHg was a significant
predictor of mortality and remained so after adjusting for age and sex. The Kaplan-Meier survival
analysis showed that patients with RVSP > 55 mmHg and those with TAPSE/RVSP ratio < 0.42 mm/mmHg had a lower survival probability.
Conclusions: TAPSE/RVSP < 0.42 mm/mmHg is a strong predictor of short-term mortality in patients
with SMR when considered for valve surgery.

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