EMBARGOED UNTIL 2:15PM, May 16, 2022
Newswise — Boston, MA (May 16, 2022) - In a recent CTSN trial, the addition of tricuspid annuloplasty (TA) at the time of mitral valve surgery (MVS) in patients with degenerative mitral regurgitation (MR) and moderate or less tricuspid regurgitation (TR) reduced the composite rate of death, reoperation for TR, or TR progression at two years. This outcome, however, was counterbalanced by an increased incidence of permanent pacemaker (PPM) implantation.
The authors looked at the data for 399 of the 401 patients to analyze the timing, indications, and risk factors of PPM. Within two years of the initial study, 30 of the patients who had MVS+TA had received PPMs, and six of those who had MVS alone. The majority of those implants (29) occurred within 30 days of surgery.
Potential risk factors (baseline characteristics, echocardiographic parameters, and operative details) were compared between patients with and without PPM. Univariate analysis identified age, history of AF, TA and MV procedures, concomitant MAZE, and TV annulus dimension as potential risk factors for PPM within 30 days. None of these was statistically significant.
This study identified the concomitant TA as the only independent risk factor for PPM implantation in patients undergoing MV surgery for degenerative MR.
Among patients with degenerative MV disease, 25-30% have TR. For severe cases, concomitant MVS+TV is required. The debate is about the advisability and risks for moderate to less-than-moderated cases. What is best for the patient is the first consideration.
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Presented by Gorav Ailawadi, MD, at the AATS 102nd Annual Meeting
ABOUT THE AMERICAN ASSOCIATION FOR THORACIC SURGERY (AATS)
The American Association for Thoracic Surgery (AATS) is an international organization that encourages, promotes, and stimulates the scientific investigation of cardiothoracic surgery. Founded in 1917 by a respected group of the earliest pioneers in the field, its original mission was to “foster the evolution of an interest in surgery of the Thorax.” Today, the AATS is the premiere association for cardiothoracic surgeons in the world and works to continually enhance the ability of cardiothoracic surgeons to provide the highest quality of patient care. Its more than 1,500 members have a proven record of distinction within the specialty and have made significant contributions to the care and treatment of cardiothoracic disease. Visit www.aats.org to learn more.
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