Regurgitasi trikuspid residual sebagai prediktor mortalitas dan morbiditas pasca operasi katup mitral = Residual tricuspid regurgitation as a predictor of mortality and morbidity post mitral valve surgery / Muhammad Hatta
Main Author: | Muhammad Hatta, author |
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Format: | Masters Thesis |
Terbitan: |
, 2015
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Subjects: | |
Online Access: |
http://lib.ui.ac.id/file?file=digital/2016-5/20415496-T-Muhammad Hatta.pdf |
ctrlnum |
20415496 |
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fullrecord |
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<dc schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"><title>Regurgitasi trikuspid residual sebagai prediktor mortalitas dan morbiditas pasca operasi katup mitral = Residual tricuspid regurgitation as a predictor of mortality and morbidity post mitral valve surgery / Muhammad Hatta</title><creator>Muhammad Hatta, author</creator><type>Thesis:Masters</type><place/><publisher/><date>2015</date><description>[<b>ABSTRAK</b><br>
Latar Belakang : Regurgitasi trikuspid (RT) merupakan kondisi yang seringkali
ditemukan pada penyakit katup mitral. Selama ini kondisi ini seringkali diabaikan
karena terdapat anggapan bahwa RT akan berkurang setelah pasien menjalani
operasi katup mitral. Kondisi ini ternyata tidak selalu terjadi dan seringkali pasca
operasi RT residual justru dapat berkembang seiring berjalannya waktu.
Regurgitasi trikuspid residual selama pengamatan diprediksi dapat memberikan
luaran yang buruk pasca operasi sehingga kondisi ini memerlukan tatalaksana
yang sesuai.
Tujuan : Mengetahui apakah RT residual pasca operasi katup mitral berhubungan
dengan mortalitas dan morbiditas jangka menengah pasca operasi.
Metode : Penelitian ini merupakan studi kohort retrospektif dilakukan di Rumah
Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK). Subyek penelitian
adalah pasien yang menjalani operasi katup mitral di RSJPDHK sejak Januari
2011 sampai dengan Desember 2013. Karakteristik dasar, data operasi, serta
pemeriksaan ekokardiografi sebelum dan pasca operasi (pre-discharge) yang
diperoleh dari rekam medis di catat. Data kemudian diolah dengan analisis
bivariat dan multivariat untuk mengetahui hubungan antara RT residual dengan
mortalitas dan morbiditas yaitu rehospitalisasi, klas fungsional NYHA III-IV atau
re-operasi.
Hasil Penelitian : Subyek yang diikutsertakan sebanyak 307 pasien dengan 255
pasien (83,06%) terdapat RT residual non signifikan dan 52 pasien (16,9%) RT
signifikan. Pada kelompok RT signifikan mortalitas terjadi pada 6 pasien (11,5%)
sedangkan pada RT non signifikan sebanyak 10 pasien (3,9%). Terdapat
hubungan yang bermakna antara derajat RT signifikan dengan mortalitas (OR
3,196; 95%IK 1,107-9,224; p=0,036). Sebaliknya, tidak terdapat hubungan
bermakna antara RT residual dengan morbiditas (OR 1,091; 95%IK 0,536-2,221;
p=0,810). Setelah pengamatan dengan durasi 18,7 ± 9,3 bulan terlihat 6% pasien
yang pada saat pre-discharge dengan RT residual non-signifikan berubah menjadi
RT signifikan dan fenomena ini disebut juga dengan late RT.
Kesimpulan : Pada penelitian retrospektif ini membuktikan bahwa terdapat
hubungan yang bermakna antara RT residual signifikan dengan mortalitas, namun
tidak didapatkan adanya hubungan bermakna antara RT residual dengan
morbiditas. Pada pengamatan jangka menengah tampak bahwa fenomena late RT
sudah mulai terjadi meskipun dalam jumlah yang kecil.
<hr>
<b>ABSTRACT</b><br>
Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients;Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients;Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients;Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients, Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients]</description><subject>Mortality</subject><subject>Tricuspid</subject><identifier>20415496</identifier><source>http://lib.ui.ac.id/file?file=digital/2016-5/20415496-T-Muhammad Hatta.pdf</source><recordID>20415496</recordID></dc>
|
format |
Thesis:Masters Thesis Thesis:Thesis |
author |
Muhammad Hatta, author |
title |
Regurgitasi trikuspid residual sebagai prediktor mortalitas dan morbiditas pasca operasi katup mitral = Residual tricuspid regurgitation as a predictor of mortality and morbidity post mitral valve surgery / Muhammad Hatta |
publishDate |
2015 |
topic |
Mortality Tricuspid |
url |
http://lib.ui.ac.id/file?file=digital/2016-5/20415496-T-Muhammad Hatta.pdf |
contents |
[<b>ABSTRAK</b><br>
Latar Belakang : Regurgitasi trikuspid (RT) merupakan kondisi yang seringkali
ditemukan pada penyakit katup mitral. Selama ini kondisi ini seringkali diabaikan
karena terdapat anggapan bahwa RT akan berkurang setelah pasien menjalani
operasi katup mitral. Kondisi ini ternyata tidak selalu terjadi dan seringkali pasca
operasi RT residual justru dapat berkembang seiring berjalannya waktu.
Regurgitasi trikuspid residual selama pengamatan diprediksi dapat memberikan
luaran yang buruk pasca operasi sehingga kondisi ini memerlukan tatalaksana
yang sesuai.
Tujuan : Mengetahui apakah RT residual pasca operasi katup mitral berhubungan
dengan mortalitas dan morbiditas jangka menengah pasca operasi.
Metode : Penelitian ini merupakan studi kohort retrospektif dilakukan di Rumah
Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK). Subyek penelitian
adalah pasien yang menjalani operasi katup mitral di RSJPDHK sejak Januari
2011 sampai dengan Desember 2013. Karakteristik dasar, data operasi, serta
pemeriksaan ekokardiografi sebelum dan pasca operasi (pre-discharge) yang
diperoleh dari rekam medis di catat. Data kemudian diolah dengan analisis
bivariat dan multivariat untuk mengetahui hubungan antara RT residual dengan
mortalitas dan morbiditas yaitu rehospitalisasi, klas fungsional NYHA III-IV atau
re-operasi.
Hasil Penelitian : Subyek yang diikutsertakan sebanyak 307 pasien dengan 255
pasien (83,06%) terdapat RT residual non signifikan dan 52 pasien (16,9%) RT
signifikan. Pada kelompok RT signifikan mortalitas terjadi pada 6 pasien (11,5%)
sedangkan pada RT non signifikan sebanyak 10 pasien (3,9%). Terdapat
hubungan yang bermakna antara derajat RT signifikan dengan mortalitas (OR
3,196; 95%IK 1,107-9,224; p=0,036). Sebaliknya, tidak terdapat hubungan
bermakna antara RT residual dengan morbiditas (OR 1,091; 95%IK 0,536-2,221;
p=0,810). Setelah pengamatan dengan durasi 18,7 ± 9,3 bulan terlihat 6% pasien
yang pada saat pre-discharge dengan RT residual non-signifikan berubah menjadi
RT signifikan dan fenomena ini disebut juga dengan late RT.
Kesimpulan : Pada penelitian retrospektif ini membuktikan bahwa terdapat
hubungan yang bermakna antara RT residual signifikan dengan mortalitas, namun
tidak didapatkan adanya hubungan bermakna antara RT residual dengan
morbiditas. Pada pengamatan jangka menengah tampak bahwa fenomena late RT
sudah mulai terjadi meskipun dalam jumlah yang kecil.
<hr>
<b>ABSTRACT</b><br>
Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients;Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients;Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients;Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients, Background : Tricuspid regurgitation (TR) is frequently present in patients with
mitral valve disease. Tricuspid regurgitation has long been ignored because it was
generally believed that TR can regress after succesfull mitral valve surgery.
However later studies found that this is not always true, TR can progress post
operatively. This residual can affected adversed outcome regarding mortality and
morbidty and this condition need accurate and suitable management.
Objective : The purpose of the present study was to know the outcome of residual
tricuspid regurgitation post mitral valve surgery regarding mortality and morbidity
at the mid term follow up.
Methods : A retrospectively cohort study was conducted in National
Cardiovascular Center Harapan Kita (NCCHK). We analyzed records of patients
who underwent mitral valve surgery in our hospital between January 2011 and
December 2013. Baseline and surgical characteristic, echocardiographic pre and
post operatively (pre-discharge) was evaluated. Statistycal analysis was done
using bivariate and multivariate analysis to determine the association between
residual TR regarding mortality and morbidity defined as the composite of
rehospitalization, symptom of fungsional class NYHA III-IV, or reoperation.
Results : The total 307 patients was analyzed. Of those subjects, 255 patients
(83,06%) revealed non significant residual TR and 52 patients (16,9%) with
significant TR post operatively. In patients with significant residual TR post
operatively, mortality occured in 6 patients (11,5%) compared with 10 patients
(3,9%) in non significant group. There was a significant association between
residual TR post operatively with mortality (OR 3,196; 95%IK 1,107-9,224;
p=0,036), Conversely, there was no significant association between residual TR
and morbidity (OR 1,091; 95%IK 0,536-2,221; p=0,810). After follow up with
duration 18,7 ± 9,3 months, there was 6% patients who developed from non
significant TR post operatively becoming significant TR and this phenomenon
was known as a late TR.
Conclusion : This retrospective study demonstrated that there was a significant
association between residual TR postoperatively with mortality but not with the
morbidity. During the follow up TR can progress post operatively, known as late
TR altough in this study its only found in a small number of patients] |
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