OP-180 TAPSE SCORING AND PROGNOSIS IN TRICUSPID VALVE REPLACEMENT

Introduction: Tricuspid heart valve is mostly affected by rheumatic diseases and is usually seen with mitral valve involvement. It is important to known the intervention time and route and the factors that determine mortality and morbidity. Tricuspid Annular Plane Systolic Excursion (TAPSE) is a scoring system which is performed by non-invasive doppler echocardiography and is used to determine the right ventricule function. Materials and Methods: Tricuspid valve replacement was done to 9 patients with mechanical heart valves who were operated before for the rheumatic heart valve disease. (5 bioprothesis and 4 mechanical valves). All patients were female. They all had ascites with an exercise capacity class III-IV preoperatively. Preand post-operative TAPSE scores, mean pulmonary pressures (PAP) and ejection fractions were measured. Only one patient deceased because of heart failure. (TAPSE:1.6 CM, PAB:30mmHg). Functional capacity was I-II in her outpatient control. Discussion: Tricuspid heart valve is mostly affected by rheumatic diseases and is usually seen with mitral valve involvement. Stenosis and/or regurgitation can be seen but regurgitation is the most common presentation. Severe tricuspid regurgitation which was diagnosed by echocardiography in the follow-up of patients who were previously operated because of mitral valve regurgitation, causes 50%mortality in 5 years, whereas, it was not detected any mortality in patients with moderate regurgitation. Operative mortality was 20% in a study with a 15 patients who were operated because of rheumatic heart disease. At the same study half of the patients were class III-IV according to New York Heart Association (NYHA) classification. In our study operative mortality was found 11.11 with a preoperative NYHA class III-IV and postoperative class I-II. Any of the patients has no ascites in postoperative outpatient controls. In patients who were following up for pulmonary artery hypertension, prognosis was better with TAPSE scores ≥2.0 than TAPSE scores ≤2.0 who did not have any significant difference in their mean pulmonary artery pressures. TAPSE is an important determinant of cardiac index. TAPSE