Related Experiment Video
Updated: Jul 27, 2025
08:43
Chronic Ovine Model of Right Ventricular Failure and Functional Tricuspid Regurgitation
Published on: March 17, 2023
702
Right Ventricular Reverse Remodeling After Tricuspid Valve Surgery for Significant Tricuspid Regurgitation
Xavier Galloo1,2, Maria Chiara Meucci1,3, Jan Stassen1,4
1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Structural Heart : the Journal of the Heart Team
|June 5, 2023
Summary
Significant right ventricular reverse remodeling after tricuspid valve surgery for tricuspid regurgitation is linked to improved long-term survival. Greater reduction in right ventricular end-systolic area and improved fractional area change predict better outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Tricuspid valve (TV) surgery is performed for significant tricuspid regurgitation (TR).
- The impact of TV surgery on right ventricular (RV) dimensions and function, and subsequent long-term outcomes, is not well understood.
- Evaluating RV reverse remodeling post-TV surgery is crucial for predicting patient outcomes.
Purpose of the Study:
- To assess RV reverse remodeling after TV surgery for moderate or severe TR.
- To investigate the association between RV remodeling and long-term survival.
- To identify predictors of mortality following TV surgery.
Main Methods:
- Analysis of 121 patients who underwent TV surgery for significant TR.
- Stratification of patients based on tertiles of RV end-systolic area (RVESA) reduction and RV fractional area change (RVFAC) improvement.
- Comparison of 5-year mortality rates across remodeling tertiles and investigation of independent mortality predictors.
Main Results:
- Patients in the highest tertile of RVESA reduction (≥17.2%) and RVFAC improvement (≥2.3%) showed significantly better 5-year survival rates.
- Survival rates for the best remodeling tertile (tertile 3) were 90% for RVESA and 87% for RVFAC, compared to lower tertiles.
- Both significant RVESA reduction and RVFAC improvement were independently associated with improved survival post-TV surgery.
Conclusions:
- The degree of RV reverse remodeling, quantified by RVESA reduction and RVFAC improvement, is associated with enhanced survival after TV surgery for TR.
- Achieving substantial RV reverse remodeling is a positive prognostic indicator for patients undergoing TV surgery.
- These findings highlight the importance of assessing RV remodeling for long-term outcome prediction in TR patients.
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