Background: The development of significant tricuspid regurgitation (TR) is associated with
an unfavorable clinical outcome in patients with systemic right ventricles. Increased knowledge
about the factors contributing to its presence would help prevent its progression.
Methods: This was a retrospective analysis of the factors predictive of significant TR in
60 patients with systemic right ventricles following an atrial switch procedure for complete
transposition of the great arteries. Data from echocardiographic examinations, exercise
radionuclide angiography, and myocardial perfusion imaging were analyzed.
Results: Significant TR was present in 20% of patients. Compared to patients without significant
TR, patients with significant TR were older at the time of surgery (p ≤ 0.001), with a higher
body mass index (p ≤ 0.005), lower right ventricular ejection fraction (RVEF; p ≤ 0.01),
higher exercise perfusion abnormalities score on radionuclide angiography (p ≤ 0.03), and
higher systolic blood pressure (p ≤ 0.02). At univariate logistic regression analysis systolic
blood pressure (p = 0.03), increasing age at surgery (p = 0.01), and RVEF (p = 0.02), were
predictors of significant tricuspid regurgitation. The latter two remained significant at
multivariate analysis.
Conclusions: Patients operated upon later in life, with decreased RVEF and higher blood
pressure, are at risk of significant tricuspid regurgitation and therefore warrant special attention.
Prospective studies are needed to ascertain whether appropriate pharmacological intervention
would prevent the development and/or progression of TR in these patients. (Cardiol J
2010; 17, 1: 29-34