In the no/mild TR group one patient underwent implantation of biventricular assist device as bridge to retransplantation and one patient underwent coronary artery bypass grafting. The relationship between the development of significant TR at the end of the http://www.selleckchem.com/products/VX-770.html follow-up period and echocardiographic parameters (as measured in the last echocardiographic exam) is depicted in Figure 4. Patients in the significant TR group showed significantly higher values of estimated systolic pulmonary artery pressure, lower left ventricular ejection fraction, increased right ventricular dilatation, and worse levels of right ventricular dysfunction compared to the no/mild TR group. Figure 4 Relationship between late TR severity and echocardiographic parameters TR, tricuspid regurgitation; LVEF, left ventricular ejection fraction; RV, right ventricle.

*Data are presented as median and range (min�Cmax). **% Patients with right ventricular … 4. Discussion TR after OHT Inhibitors,Modulators,Libraries is a common problem, varying in prevalence between 5.5% and 54% (Table 5). Although comparing different series may be problematic because studies vary in the length of followup, in the definition of significant TR and in the technique used for TR diagnosis, all reported series except one [25] demonstrated a higher prevalence of TR at the end of Inhibitors,Modulators,Libraries the followup in comparison to our study (14.1%). Marelli et al. [4] in a cohort of 670 patients found freedom from significant TR of 78% at 9 years. Our analysis demonstrated a slightly higher rate of 85.2% at 10 years (Figure 2), similar to the 85.8% at 10 years rate demonstrated by Chan et al.

Inhibitors,Modulators,Libraries [3]. Table 5 Prevalence of TR after OHT. Regardless of the incidence Inhibitors,Modulators,Libraries of its occurrence, all reported series [2, 4, 5, 14] have demonstrated an increased mortality among patients who have developed postoperative significant TR, ranging from 15% to 62.5%. Similarly, while the overall mortality rate during the follow-up period (average 8.2 �� 4.6 years) in our study was 31.3%, similar to the reported ISHLT registry data [29], the mortality rate in the significant TR group was higher compared with the no/mild TR group (47.8% versus 28.6%), and this difference was of borderline significance (P = 0.065); the Kaplan-Meier survival analysis did not demonstrate a significant difference between the two groups in our study.

Moreover, the development of significant TR is associated with Inhibitors,Modulators,Libraries the significant morbidity of the right heart failure Drug_discovery and with the increased necessity to undergo repeat operations to repair or replace the regurgitant tricuspid valve, as evident in our series. Thus it is of paramount importance to identify the risk factors associated with this potentially lethal complication in order to try and avoid them. The etiology of postoperative TR after OHT is no doubt multifactorial and several preoperative, intraoperative, and postoperative features have been implicated as potential causative factors.