HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Raffaele De Simone Falk-Udo Sack Siegfried Hagl Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by De Simone, R. Articles by Hagl, S. Search for Related Content PubMed PubMed Citation Articles by De Simone, R. Articles by Hagl, S.

Ann Thorac Surg 1995;60:1686-1693
© 1995 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Atrioventricular Valve Insufficiency and Atrial Geometry After Orthotopic Heart Transplantation

Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany

Accepted for publication July 17, 1995.

Background. The etiology of tricuspid and mitral valve regurgitation (TR and MR) after heart transplantation is still controversial.

Methods. We studied 25 patients undergoing transplantation and intraoperative transesophageal echocardiography to evaluate the incidence, the degree, and the cause of TR and MR. The degree of valve regurgitation was assessed by color Doppler echocardiography. Cross-sectional areas of the recipient (R) and donor (D) portions of the atria and their ratio (R/D) were measured to assess the distortion of atrial geometry. Tricuspid and mitral valve annuli, their systolic shortening, and hemodynamic indices were measured preoperatively and perioperatively.

Results. Tricuspid valve regurgitation was found in 21 of 25 patients (84%) and MR in 12 of 25 (48%). The degree of MR was mild, whereas TR was mild to moderate. Mitral valve regurgitation did not show any correlation with the studied indices; TR showed no correlation with the hemodynamic indices but a significant correlation with R/D ratio (r = 0.90; standard error of the estimate = 0.2). An inverse correlation was found between the degree of TR and systolic shortening of tricuspid annulus (r = -0.88; standard error of the estimate = 0.03) and between R/D ratio and systolic shortening of tricuspid annulus (r = -0.85; standard error of the estimate = 0.04).

Conclusions. Tricuspid valve regurgitation has a higher incidence than MR and occurs immediately after transplantation; MR is mild and correlates with neither hemodynamic indices nor atrial distortion. An increased R/D ratio, and hence distortion of right atrial geometry, may lead to a reduction in systolic annulus shortening, which in turn causes TR. Surgical attempts to reduce the R/D ratio may decrease the incidence and the degree of TR after heart transplantation.

This article has been cited by other articles:

				M. Yoshikawa, S. Tomari, A. Usui, and Y. Ueda Surgical Repair of Mitral and Tricuspid Valves After Cardiac Transplantation Asian Cardiovasc Thorac Ann, June 1, 2009; 17(3): 294 - 296. [Abstract] [Full Text] [PDF]

				M. Asano, A. J. Razzouk, R. E. Chinnock, and L. L. Bailey Geometric Disproportion of Cardiac Structure and Graft Ischemia Affect Tricuspid Valve Regurgitation Early After Neonatal Heart Transplantation Ann. Thorac. Surg., May 1, 2007; 83(5): 1774 - 1780. [Abstract] [Full Text] [PDF]

				A. Koch, A. Remppis, T. J. Dengler, P. A. Schnabel, S. Hagl, and F.-U. Sack Influence of different implantation techniques on AV valve competence after orthotopic heart transplantation Eur. J. Cardiothorac. Surg., November 1, 2005; 28(5): 717 - 723. [Abstract] [Full Text] [PDF]

				R. De Simone, I. Wolf, S. Mottl-Link, B. W. Bottiger, H. Rauch, H.-P. Meinzer, and S. Hagl Intraoperative assessment of right ventricular volume and function Eur. J. Cardiothorac. Surg., June 1, 2005; 27(6): 988 - 993. [Abstract] [Full Text] [PDF]

				C Schellemans, W Tack, and M Vanderheyden Acute type A aortic dissection in a cardiac allograft recipient: case report and review of the literature Heart, November 1, 2004; 90(11): 1256 - 1258. [Abstract] [Full Text] [PDF]

				G McDowell, M Cave, A Bainbridge, M Danton, C Shaw, K.D Buchanan, J Wallwork, S Large, and D.P Nicholls Is the secretion of atrial natriuretic peptide in man under neural control? Eur. Heart J., March 2, 2000; 21(6): 498 - 503. [Abstract] [PDF]

				M. Vigano, M. Rinaldi, A. M. D’Armini, C. Pederzolli, G. Minzioni, and A. M. Grande The spectrum of aortic complications after heart transplantation Ann. Thorac. Surg., July 1, 1999; 68(1): 105 - 111. [Abstract] [Full Text] [PDF]

				R. De Simone, G. Glombitza, C.-F. Vahl, J. Albers, H.-P. Meinzer, and S. Hagl Assessment of mitral regurgitant jets by three-dimensional color Doppler Ann. Thorac. Surg., February 1, 1999; 67(2): 494 - 499. [Abstract] [Full Text] [PDF]

				R. De Simone, G. Glombitza, C.-F. Vahl, J. Albers, H.-P. Meinzer, and S. Hagl Three-dimensional color Doppler for assessing mitral regurgitation during valvuloplasty Eur. J. Cardiothorac. Surg., February 1, 1999; 15(2): 127 - 133. [Abstract] [Full Text] [PDF]