Tricuspid Regurgitation After Heart Transplantation: The Cause or the Result of Graft Dysfunction?

Bart, Nicole K. and Hungerford, Sara L. and Namasivayam, Mayooran and Granger, Emily and Conellan, Mark and Kotlyar, Eugene and Muthiah, Kavitha and Jabbour, Andrew and Hayward, Christopher and Jansz, Paul C. and Keogh, Anne M. and Macdonald, Peter S. (2023) Tricuspid Regurgitation After Heart Transplantation: The Cause or the Result of Graft Dysfunction? Transplantation, 107 (6). pp.1390-1397. ISSN 0041-1337

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BACKGROUND: Tricuspid regurgitation (TR) is common following heart transplantation and has been shown to adversely influence patient outcomes. The aim of this study was to identify causes of progression to moderate-severe TR in the first 2 y after transplantation. METHODS: This was a retrospective, single-center study of all patients who underwent heart transplantation over a 6-y period. Transthoracic echocardiogram (TTE) was performed at month 0, between 6 and 12 mo, and 1-2 y postoperatively to determine the presence and severity of TR. RESULTS: A total of 163 patients were included, of whom 142 underwent TTE before first endomyocardial biopsy. At month 0, 127 (78%) patients had nil-mild TR before first biopsy, whereas 36 (22%) had moderate-severe TR. In patients with nil-mild TR, 9 (7%) progressed to moderate-severe TR by 6 mo and 1 underwent tricuspid valve (TV) surgery. Of patients with moderate-severe TR before first biopsy, by 2 y, 3 had undergone TV surgery. The use of postoperative extracorporeal membrane oxygenation (ECMO) in the latter group was significant (78%; P < 0.05) as was rejection profile ( P = 0.02). Patients with late progressive moderate-severe TR had a significantly higher 2-y mortality than those who had moderate-severe TR immediately. CONCLUSIONS: Overall, our study has shown that in the 2 main groups of interest (early moderate-severe TR and progression from nil-mild to moderate-severe TR), TR is more likely to be the result of significant underling graft dysfunction rather than the cause of it.

Item Type: Article
Subjects: R Medicine > R Medicine (General)
Depositing User: Repository Administrator
Date Deposited: 06 Jul 2023 01:23
Last Modified: 06 Jul 2023 01:26

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