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CHANGES IN RIGHT VENTRICLE AND RIGHT ATRIUM FUNCTION FOLLOWING MITRAL VALVE REPAIR FOR PRIMARY MITRAL REGURGITATION

N. Elmasry, H. W. Wu, M. Palmen, J. Bax, N. Ajmone Marsan (Leiden, Netherlands)
Topic: Echocardiography
Type: Presentation - doctors, CCVRID 2024

Background:
The assessment of right heart function following cardiac surgery remains a challenge.


Aims:
To assess changes in echocardiographic measures of the right ventricle (RV) and right atrium after mitral valve surgery.


Methods:
A total of 255 patients undergoing surgery for primary mitral regurgitation were included. Measurements were compared before and immediately after surgery (pre-discharge), and included tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), RV longitudinal (RVLS) and free wall (RVFWLS) strains, and right atrial volume index and reservoir strain.


Results:
As compared to baseline values, TAPSE (23 vs 11 mm; p <0.001), RVLS (-19.8 vs -15.3 %; p <0.001) and RVFWLS (-23.9 vs -16.7 %; p <0.001) significantly decreased after surgery, while FAC did not show a significant change (41% vs 42%; p = 0.22). Right atrial reservoir strain also showed a significant decrease after surgery (29.9 vs 9.5%; p <0.001). Patients who received concomitant tricuspid valve repair (n = 115; 45%) experienced significantly higher drop in TAPSE (p = 0.04) but significantly lower drop in right atrial strain (p <0.001). Right atrial volume index decreased only in patients who received tricuspid valve repair (38 vs 25 ml/m2; p <0.001).


Conclusions:
Following surgery for primary mitral regurgitation, all parameters of RV function showed a significant decrease except for FAC. Similarly, right atrial function, as measured by strain, decreased significantly after surgery.