Abstract
Objective: definition operative tactics of correction concomitant tricuspid insufficiency in aortic stenosis.
Material and methods. In meta-analysis included 1513 patients with isolated aortic stenosis and concomitant tricuspid insufficiency. Literature search of all articles carried out in the following databases from January 2000 to may 2017: PubMed and Medscape. Statistical analysis was performed by comparing 2 groups of patients: I group – patients with isolated aortic stenosis and concomitant tricuspid regurgitation 2+ (severe) (n=253) and II group – patients with isolated aortic stenosis and concomitant tricuspid regurgitation up to 2nd degree (n=1260). Statistical analysis was performed using Excel and Statistica 7.0.
Results. Mortality rate was statistically significantly higher in the 1st group – 29.6% (68 patients) versus 15% (175 patients) in group II. In the late postoperative period, in both groups there was a slight progression of tricuspid insufficiency (2.2±0.7 in the I group and 1.3±0.6 in the 2 group, p<0.001). The influence of the following risk factors on the progression of residual tricuspid regurgitation was established: atrial fibrillation, the presence of a pacemaker, concomitant mitral insufficiency and the severity of left ventricular hypertrophy.
Conclusion. According to the results of the study, in determining the operative tactics of concomitant tricuspid insufficiency, in addition to the main indications (recommendations), it is necessary to pay attention to the presence of atrial fibrillation, previously implanted with pacemakers, the presence of concomitant mitral insufficiency and the severity of left ventricular hypertrophy.
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About the authors
- Skopin Ivan Ivanovich, Dr. Med. Sc., Professor, Head of Department, Director of Institute for Coronary and Vascular Surgery; orcid.org/0000-0001-7411-202X
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Latyshev Mikhail Sergeevich, Postgraduate; orcid.org/0000-0003-1771-4264
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Vavilov Aleksandr Vladimirovich, Cardiovascular Surgeon; orcid.org/0000-0002-0488-5630
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Asatryan Tigran Vladimirovich, Researcher; orcid.org/0000-0002-0141-5481
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Dremin Aleksandr Valentinovich, Junior Researcher; orcid.org/0000-0003-3036-9493
