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Thorac Cardiovasc Surg
DOI: 10.1055/s-0044-1789248
Short Communication

Survival Correlates with Regurgitation Degree Before and After Invasive Atrioventricular Valve Treatment

Torsten Doenst
1   Department of Cardiothoracic Surgery, University Hospital Jena, Jena, Germany
,
Tulio Caldonazo
2   Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, University Hospital, Jena, Germany
,
Murat Mukharyamov
2   Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, University Hospital, Jena, Germany
,
Panagiotis Tasoudis
3   The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
,
Hristo Kirov
2   Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, University Hospital, Jena, Germany
› Author Affiliations Funding T.C. was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Clinician Scientist Program OrganAge funding number 413668513, by the Deutsche Herzstiftung (DHS, German Heart Foundation) funding number S/03/23 and by the Interdisciplinary Center of Clinical Research of the Medical Faculty Jena.
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Abstract

The degree of both mitral (MR) and tricuspid valve regurgitation (TR) correlates with mortality. A vicious cycle has been proposed consisting of increasing regurgitation and decreasing ventricular function. Restoration of valve competence should break this vicious cycle and improve life expectancy. However, a “pop-off” mechanism keeps being entertained, presumably allowing poorly pumping ventricles to relieve volume into the low-pressure atrium through an incomplete repair, avoiding pump failure. We reasoned that if such a mechanism exists, it should offset the relationship between mortality and valve regurgitation after an invasive procedure. In this context, we meta-analytically compared valve regurgitation degree and survival before or after atrio-ventricular valve treatment. The results show significant relationships between valve regurgitation and mortality under all conditions (i.e., before and after surgery or intervention) and irrespective of the underlying pathology (i.e., functional or structural). In summary, the ubiquitously present relationship between valve regurgitation and mortality suggests that generating a tight and durable repair of the affected valve is key to long-term exploitation of a symptom-reducing and life-prologing mechanism, independent of the underlying valve pathology. This recognition may explain current controversies in the treatment effects of MR and TR.

Keywords

valve surgery - regurgitation - valve repair

Data Availability Statement

All information given in the manuscript is subject to sharing through contact with the corresponding author. The data underlying this article are available in the article and its online supplementary material.




Publication History

Received: 02 March 2024

Accepted: 02 August 2024

Article published online:
13 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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