Progression or persistence of tricuspid regurgitation after mitral valve replacement in patients with pre-operative moderate tricuspid regurgitation
- PMID: 40860393
- PMCID: PMC12373572
- DOI: 10.1007/s12055-025-01965-0
Progression or persistence of tricuspid regurgitation after mitral valve replacement in patients with pre-operative moderate tricuspid regurgitation
Abstract
Purpose: There is a paucity of data on factors contributing to post-operative tricuspid regurgitation among patients with pre-operative moderate functional tricuspid regurgitation undergoing mitral valve replacement for rheumatic heart disease, the most common cause of mitral valve disease in the developing world.
Methods: Between January 2013 and December 2018, 476 patients underwent mitral valve replacement in our institution, of which 135 fulfilled the exclusion criteria. Of the remaining 341 patients, 142 had moderate functional tricuspid regurgitation. Our primary objective was to estimate the number of patients with of post-operative moderate to severe tricuspid regurgitation. Secondary outcomes were to determine the factors associated with it.
Results: Among the 142 patients who had pre-operative moderate functional tricuspid regurgitation (TR), mitral stenosis (46.4%) was the predominant lesion. Concomitant tricuspid annuloplasty (TAP) was done in 41 patients (28.9%). The median duration of follow-up was 35 (11, 79.5) months. Post-operative moderate to severe TR was recorded in 41.5%. Atrial fibrillation was significantly associated with post-operative moderate to severe TR (p = 0.006). Among the patients who did not undergo TAP, post-operative moderate to severe TR (85%, 50/59) compared to post-operative mild TR (61%, 51/83) with a p-value of 0.003.
Conclusion: Our data show that concomitant tricuspid annuloplasty during mitral valve replacement can be considered even in patients with pre-operative moderate TR and that pre-operative atrial fibrillation is significantly associated with post-operative TR.
Supplementary information: The online version contains supplementary material available at 10.1007/s12055-025-01965-0.
Keywords: Tricuspid valve insufficiency; Rheumatic heart disease; Tricuspid annuloplasty; Atrial fibrillation.
© Indian Association of Cardiovascular-Thoracic Surgeons 2025. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
Conflict of interest statement
Conflict of interestNone.
References
-
- Nath J, Foster E, Heidenreich PA. Impact of tricuspid regurgitation on long-term survival. J Am Coll Cardiol. 2004;43:405–9. - PubMed
-
- Karthikeyan G. Rheumatic heart disease in India: declining, but not fast enough. Natl Med J India. 2017;30:247–48. 10.4103/0970-258X.234389. - PubMed
-
- Lancellotti P, Moura L, Pierard LA, Agricola E, Popescu BA, Tribouilloy C, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr. 2010;11:307–32. - PubMed
-
- Kim JB, Yoo DG, Kim GS, Song H, Jung S-H, Choo SJ, et al. Mild-to-moderate functional tricuspid regurgitation in patients undergoing valve replacement for rheumatic mitral disease: the influence of tricuspid valve repair on clinical and echocardiographic outcomes. Heart Br Card Soc. 2012;98:24–30. - PubMed
-
- Song H, Kim M-J, Chung CH, Choo SJ, Song MG, Song J-M, et al. Factors associated with development of late significant tricuspid regurgitation after successful left-sided valve surgery. Heart Br Card Soc. 2009;95:931–6. - PubMed
LinkOut - more resources
Miscellaneous