Objective We sought to use echocardiography for the comparisons of pre and post-surgical cardiac structure and function and evaluation of the prognostic value of tricuspid regurgitation for the patients with rheumatic heart disease who underwent prosthetic heart valve replacement surgery.Methods We enrolled 50 patients

50 healthy volunteers.For the comparisons among one week before and three months after surgery of the patients and control group

we measured the dimension of left atrium(LA)

the dimension of right atrium(RA)

diastolic dimension of left ventricle(LV)

diastolic dimension of right ventricle(RV)

left ventricular ejection fraction(LVEF)

right ventricular ejection fraction(RVEF)

diastolic dimension of tricuspid annulus(TD)

systolic dimension of tricuspid annulus(TS)for the calculation of tricuspid annulus shortening rate [Rt

Rt=(TD-TS)/TD]

manual delineated contours of tricuspid regurgitation area(TRA) for the calculation of the ratio of TRA to right atrial area(TRA/RAA) and maximal regurgitant velocity(V) for the estimation of pulmonary arterial systolic pressure(PASP

PASP=4V2+10).Results LA

RA

LV

RV

LVEF

RVEF

Rt

TRA/RAA and PASP of the patients were significantly different from those of the control group(p <0.05).According to TRA/RAA

TR was classified into mild

moderate and severe groups.Compared to mild group

RV

TRA/RAA

Rt and PASP of moderate and severe groups were higher(p<0.05 for RV

Rt and PASP);Statistical significance of RV and PASP was shown for the comparison between moderate and severe group(p<0.05)while there was no signal for RA

RVEF and Rt.For the comparison of the patients between one week before and three months after surgery

statistical significances were shown for LA

RA

RV

LVEF

RVEF

Rt

TRA/RAA and PASP(p<0.05) except LV.In addition

we compared the patients who underwent tricuspid valvuloplasty and who didn’t

and the results showed that RA

Rt

TRA/RAA and PASP were significantly different(p<0.05) while RA and RVEF were not.In 21 patients with moderate or severe tricuspid regurgitation(TR) who underwent tricuspid valvuloplasty

TR of 14 cases(67%) were recovered while of 7 cases(33%) were classified into mild after surgery.Conclusions The Doppler assessments of right ventricular function and pulmonary artery before surgery would be credited to the necessity of tricuspid valvuloplasty during the surgery of mitral valve replacement.