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Prognostic Value of Hepatorenal Function by MELD Score in Patients with Tricuspid Annuloplasty.

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eMediNexus    17 July 2018

A new study published in the Journal of the American Heart Association aimed to determine the prognostic value of hepato-renal function in patients undergoing tricuspid annuloplasty. This study evaluated 394 patients who underwent tricuspid annuloplasty. In these patients, baseline clinical, laboratory, and echocardiographic parameters were recorded. The results showed that patients who underwent tricuspid annuloplasty had a high prevalence of preoperative hepatorenal dysfunction, which was more common in patients with severe tricuspid regurgitation than in those with mild-to-moderate tricuspid regurgitation. Additionally, MELD-XI and MELD-Albumin scores were excellent predictors of 1-year adverse outcomes. While a high score on MELD-XI and MELD-Albumin was associated with an increased risk of adverse events. During a median follow-up of 40 months, both MELD-XI and MELD-Albumin scores were significantly associated with adverse outcomes. Meanwhile, significant improvement of hepatorenal function at 1 year postoperation was noted only in patients who had no adverse events, and not in those who experienced an adverse outcome. Hence, it was concluded that both MELD-XI score and MELD-Albumin score can provide useful information to predict adverse outcome in patients undergoing tricuspid annuloplasty. Monitoring of modified MELD score was recommended to improve preoperative risk stratification of these patients.

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