Effects of right ventricular morphology and function on outcomes of patients with degenerative mitral valve disease Ying Ye, BS, Ravi Desai, MD, Lina.

Slides:

Advertisements

Similar presentations

Tomislav Mihaljevic, MD, Edward R

Advertisements

Moderate Tricuspid Regurgitation With Left-Sided Degenerative Heart Valve Disease: To Repair or Not to Repair? Jose L. Navia, MD, Nicolas A. Brozzi,

Spinal cord protective strategies during descending and thoracoabdominal aortic aneurysm repair in the modern era: The role of intrathecal papaverine

Residual patient, anatomic, and surgical obstacles in treating active left-sided infective endocarditis Syed T. Hussain, MD, Nabin K. Shrestha, MD, Steven.

Generating New Knowledge in Cardiac Interventions

Surgical management of secondary tricuspid valve regurgitation: Annulus, commissure, or leaflet procedure? Jose L. Navia, MD, Edward R. Nowicki, MD,

Moderate Tricuspid Regurgitation With Left-Sided Degenerative Heart Valve Disease: To Repair or Not to Repair? Jose L. Navia, MD, Nicolas A. Brozzi,

Advising complex patients who require complex heart operations

Should lung transplantation be performed for patients on mechanical respiratory support? The US experience David P. Mason, MD, Lucy Thuita, MS, Edward.

Lars G. Svensson, MD, PhD, Lillian H. Batizy, MS, Eugene H

Effect of changes in postoperative spirometry on survival after lung transplantation David P. Mason, MD, Jeevanantham Rajeswaran, MSc, Liang Li, PhD,

Endovascular versus open elephant trunk completion for extensive aortic disease Eric E. Roselli, MD, Sreekumar Subramanian, MD, Zhiyuan Sun, BS, Jahanzaib.

The least of 3 evils: Exposure to red blood cell transfusion, anemia, or both? Gabriel Loor, MD, Jeevanantham Rajeswaran, PhD, Liang Li, PhD, Joseph F.

Surgical treatment of pseudoaneurysm of the thoracic aorta

Edwin C. McGee, MD, A. Marc Gillinov, MD, Eugene H

Lindsay R. Freud, MD, Gerald R. Marx, MD, Audrey C

Duration of inotropic support after left ventricular assist device implantation: Risk factors and impact on outcome Soren Schenk, MD, Patrick M. McCarthy,

Pulmonary hypertension in valve disease: A beast of the past?

Clostridium difficile infection after cardiac surgery: Prevalence, morbidity, mortality, and resource utilization Suresh Keshavamurthy, MBBS, MS, Colleen.

Coronary artery bypass grafting in diabetics: A growing health care cost crisis Sajjad Raza, MD, Joseph F. Sabik, MD, Ponnuthurai Ainkaran, MS, Eugene.

Surgical Repair of Posterior Mitral Valve Prolapse: Implications for Guidelines and Percutaneous Repair Douglas R. Johnston, MD, A. Marc Gillinov, MD,

Surgical management of competing pulmonary blood flow affects survival before Fontan/Kreutzer completion in patients with tricuspid atresia type I Travis.

Tricuspid valve repair: durability and risk factors for failure

Albert S. Y. Chang, MD, Nicholas G. Smedira, MD, Catherine L

Multilevel data analysis: What? Why? How?

Syed T. Hussain, MD, Kwabena Mawulawde, MD, Samir R

Spinal cord protective strategies during descending and thoracoabdominal aortic aneurysm repair in the modern era: The role of intrathecal papaverine

Does a similar procedure result in similar survival for women and men undergoing isolated coronary artery bypass grafting? Tamer Attia, MD, MSc, Colleen.

Success and limitations of right ventricular sinus myectomy for pulmonary atresia with intact ventricular septum Roosevelt Bryant, MD, Edward R. Nowicki,

Simple versus complex degenerative mitral valve disease

A. Marc Gillinov, MD, Eugene H. Blackstone, MD, Edward R

Capturing echocardiographic allograft valve function over time after allograft aortic valve or root replacement M. Mostafa Mokhles, PhD, MSc, Jeevanantham.

Ahmad Zeeshan, MD, Jay J. Idrees, MD, Douglas R

Tricuspid Regurgitation Associated With Ischemic Mitral Regurgitation: Characterization, Evolution After Mitral Surgery, and Value of Tricuspid Repair

Understanding right ventricular dysfunction and functional tricuspid regurgitation accompanying mitral valve disease Lina Maria Vargas Abello, MD, Allan.

Travis J. Wilder, MD, Brian W. McCrindle, MD, Edward J

Gabriel Loor, MD, Liang Li, PhD, Joseph F

Atrial fibrillation complicating lung cancer resection

Long-Term Durability of Bicuspid Aortic Valve Repair

A. Marc Gillinov, MD, Patrick M. McCarthy, MD, Eugene H

Reduced survival in women after valve surgery for aortic regurgitationEffect of aortic enlargement and late aortic rupture Monica L. McDonald, MDa, Nicholas.

Outcomes of less invasive J-incision approach to aortic valve surgery

Natural history of coexistent tricuspid regurgitation in patients with degenerative mitral valve disease: Implications for future guidelines Andrew B.

Surgical management of aortopulmonary window associated with interrupted aortic arch: A Congenital Heart Surgeons Society study Igor E. Konstantinov,

Distal aortic interventions after repair of ascending dissection: The argument for a more aggressive approach Eric E. Roselli, MD, Gabriel Loor, MD,

Sudish C. Murthy, MD, PhD, Edward R. Nowicki, MD, MS, David P

Tricuspid annular plane systolic excursion: The welcome parameter

Edge-to-edge (Alfieri) mitral repair: results in diverse clinical settings Sunil K Bhudia, MD, Patrick M McCarthy, MD, Nicholas G Smedira, MD, Buu-Khanh.

Are allografts the biologic valve of choice for aortic valve replacement in nonelderly patients? Comparison of explantation for structural valve deterioration.

David P. Mason, MD, Dale H. Marsh, MD, Joan M. Alster, MS, Sudish C

Decision support in surgical management of ischemic cardiomyopathy

Echocardiographic approach to the decision-making process for tricuspid valve repair Farideh Roshanali, MD, Bahare Saidi, MD, Mohammad Hossein Mandegar,

Surgery for aortic and mitral valve disease in the United States: A trend of change in surgical practice between 1998 and 2005 Scott D. Barnett, PhD,

Mitral Valve Abnormalities in Hypertrophic Cardiomyopathy: Echocardiographic Features and Surgical Outcomes Ryan K. Kaple, BS, Ross T. Murphy, MD, Linda.

Lars G. Svensson, MD, PhD, Fernando A. Atik, MD, Delos M

Jeevanantham Rajeswaran, PhD, Eugene H. Blackstone, MD

Fenton H. McCarthy, MD, MS, Nimesh D. Desai, MD, PhD

Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings Bettina Pfannmüller, MD, Torsten Doenst, MD, PHD, Katja Eberhardt,

Colleen G. Koch, MD, MS, MBA, Edward R

Ventilatory dependency after cardiovascular surgery

Douglas R. Johnston, MD, Edward G

Turki B. Albacker, MD, MSc, Eugene H. Blackstone, MD, Sarah J

Mitral valve repair with aortic valve replacement is superior to double valve replacement A.Marc Gillinov, MD, Eugene H Blackstone, MD, Delos M Cosgrove,

Siva Raja, MD, PhD, Jay J. Idrees, MD, Eugene H

Regional wall motion abnormalities and scarring in severe functional ischemic mitral regurgitation: A pilot cardiovascular magnetic resonance imaging.

Pulmonary hypertension is associated with worse early and late outcomes after aortic valve replacement: Implications for transcatheter aortic valve replacement

A. Marc Gillinov, MD, Jon Sirak, MD, Eugene H

Tricuspid annulus diameter does not predict the development of tricuspid regurgitation after mitral valve repair for mitral regurgitation due to degenerative.

Identifying risk factors: Challenges of separating signal from noise

Fernando A. Atik, MD, Lars G. Svensson, MD, PhD, FACC, Eugene H

Presentation transcript:

Effects of right ventricular morphology and function on outcomes of patients with degenerative mitral valve disease Ying Ye, BS, Ravi Desai, MD, Lina M. Vargas Abello, MD, Jeevanantham Rajeswaran, PhD, Allan L. Klein, MD, Eugene H. Blackstone, MD, Gösta B. Pettersson, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 148, Issue 5, Pages 2012-2020.e8 (November 2014) DOI: 10.1016/j.jtcvs.2014.02.082 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Relationship of preoperative risk factors to 5-year survival after mitral valve surgery with or without concomitant TV repair. A, Preoperative RV MPI. Solid line represents point estimates enclosed within a 68% confidence band for an individual with left ventricular end-systolic volume index = 25 mL·m−2, no complete heart block/pacer, left atrial diameter = 4.2 to 4.7 cm, mitral valve repair, no history of smoking, BUN = 20 mg·dL−1, and aortic clamp time = 72 minutes. B, Preoperative BUN. Depiction is as in (A) except that MPI has been set at 0.42. BUN, Blood urea nitrogen; MPI, myocardial performance index. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Instantaneous risk of death and postoperative TAPSE. Orange dashed line depicts the temporal trend of postoperative TAPSE. Blue solid line represents parametric estimate of risk of death. (Note expansion of early deaths compared with Figure E3, A.) TAPSE, Tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Appendix Figure E1 Interobserver correlation for TAPSE. A, Scatter plot. Black line represents linear trend of correlation between TAPSE measurements made by observers 1 and 5. B, Bland–Altman plot for TAPSE measurements made by observers 1 and 5. TAPSE, Tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Appendix Figure E2 Interobserver correlation for MPI. A, Scatter plot. Black line represents linear trend of correlation between MPI measurements made by observers 1 and 5. B, Bland–Altman plot for MPI measurements made by observers 1 and 5. MPI, Myocardial performance index. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Appendix Figure E3 Intraobserver correlation for TAPSE. A, Scatter plot. Black line represents linear trend of correlation between TAPSE measurements made by observer 1 on 2 different occasions. B, Bland–Altman plot for TAPSE measurements made by observer 1 on 2 different occasions. TAPSE, Tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Appendix Figure E4 Intraobserver correlation for MPI. A, Scatter plot. Black line represents linear trend of correlation between MPI measurements made by observer 1 on 2 different occasions. B, Bland–Altman plot for MPI measurements made by observer 1 on 2 different occasions. MPI, Myocardial performance index. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Number of patients with echocardiographic measurements available at and beyond various time points, and number of echocardiographic measurements available for analysis. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Percentage of preoperative echocardiograms (781 total) with nonmissing values for indicated variables. MPI, Myocardial performance index; RA, right atrial; RV, right ventricular; RVOT, right ventricular outflow tract; TAPSE, tricuspid annular plane systolic excursion; TR, tricuspid regurgitation; TV, tricuspid valve. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 Mean TAPSE over time. Solid line represents unadjusted estimates of temporal trend of the mean response of postoperative TAPSE. Symbols represent data grouped (without regard to repeated measurements) within time frame to provide a crude verification of model fit. TAPSE, Tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E4 Mean MPI over time. Solid line represents unadjusted estimates of temporal trend of the mean response of postoperative MPI. Symbols represent data grouped (without regard to repeated measurements) within time frame to provide a crude verification of model fit. MPI, Myocardial performance index. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E5 Prevalence of TR grades over time after mitral valve surgery with or without concomitant TV repair. Depiction is as in Figure E4. Solid line represents unadjusted estimates of temporal trend of the prevalence of postoperative TR grades. Symbols represent data grouped (without regard to repeated measurements) within time frame to provide a crude verification of model fit. TR, Tricuspid regurgitation. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E6 Death after mitral valve surgery. A, Instantaneous risk of death (hazard function) enclosed within a 68% confidence band equivalent to ±1 standard error. B, Survival. Each circle represents a death, vertical bars represent 68% confidence limits equivalent to ±1 standard error, and numbers in parentheses represent number of patients traced beyond that point. Solid line enclosed within a dashed 68% confidence band represents parametric survival estimates. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2012-2020.e8DOI: (10.1016/j.jtcvs.2014.02.082) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions