+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

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



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 98(15): 1181; Author Reply 1181-2



The decision to repair mild-to-moderate functional tricuspid regurgitation (TR) during left-side heart surgery remains controversial.To avoid heterogeneity in patient population, patients with TR undergoing isolated mechanical mitral valve (MV) replacement for rheumatic mitral diseases were evaluated. Between 1997 and 29, 236 patients with mild-to-moderate functional TR underwent first-time isolated mechanical MV replacement for rheumatic mitral diseases with (n=123; repair group) or without (n=113; non-repair group) tricuspid valve (TV) repair. Survival, valve-related complications, and TV function in these two groups were compared after adjustment for baseline characteristics using inverse-probability-of-treatment weighting. Follow-up was complete in 225 patients (95.3%) with a median follow-up of 48.7 months (IQR 2.2–89.5 months), during which time 991 echocardiographic assessments were done. Freedom from moderate-to-severe TR at 5 years was 92.9±2.9% in the repair group and 6.8±6.9% in the non-repair group (p<.1 and .48 in crude and adjusted analyses, respectively). After adjustment, both groups had similar risks of death (HR=.57, p=.43), tricuspid reoperation (HR=.1, p=.8) and congestive heart failure (HR=1.12, p=.87). Postoperative moderate-to-severe TR was an independent predictor of poorer event-free survival (HR=2.9, p=.38). These findings support the strategy of correcting mild-to-moderate functional TR at the time of MV replacement to maintain TV function and improve clinical outcomes.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 054388123

Download citation: RISBibTeXText

PMID: 22634170

DOI: 10.1136/heartjnl-2011-301354


Related references

Tricuspid Valve Repair for the Poor Right Ventricle: Tricuspid Valve Repair in Patients with Mild-to-Moderate Tricuspid Regurgitation Undergoing Mitral Valve Repair Improves In-Hospital Outcome. Thoracic and Cardiovascular Surgeon 65(8): 612-616, 2017

Outcomes of Mild to Moderate Functional Tricuspid Regurgitation in Patients Undergoing Mitral Valve Operations: A Meta-Analysis of 2,488 Patients. Annals of Thoracic Surgery 100(6): 2398-2407, 2015

Management of moderate functional tricuspid valve regurgitation at the time of pulmonary valve replacement: is concomitant tricuspid valve repair necessary?. Pediatric Cardiology 31(6): 843-848, 2010

Mild-to-moderate functional tricuspid regurgitation in patients undergoing mitral valve surgery. Journal of Thoracic and Cardiovascular Surgery 146(5): 1092-1097, 2013

Clinical and echocardiographic impact of functional tricuspid regurgitation repair at the time of mitral valve replacement. Annals of Thoracic Surgery 88(4): 1209-1215, 2009

Clinical and Echocardiographic Impact of Functional Tricuspid Regurgitation Repair at the Time of Mitral Valve Replacement. Yearbook of Cardiology 2010: 264-266, 2010

Tricuspid valve repair for treatment and prevention of secondary tricuspid regurgitation in patients undergoing mitral valve surgery. Current Cardiology Reports 10(2): 110-117, 2008

Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. II. Nonoperative management, tricuspid valve annuloplasty, and tricuspid valve replacement. Journal of Thoracic and Cardiovascular Surgery 94(4): 488-497, 1987

Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease. Journal of Thoracic Disease 8(11): 3087-3095, 2016

Long-term results of annuloplasty in trivial-to-mild functional tricuspid regurgitation during mitral valve replacement: should we perform annuloplasty on the tricuspid valve or leave it alone?. European Journal of Cardio-Thoracic Surgery 53(4): 756-763, 2018

Tricuspid regurgitation secondary to mitral valve disease: tricuspid annulus function as guide to tricuspid valve repair. Cardiovascular Surgery 9(4): 369-377, 2001

Reduced exercise capacity in patients with tricuspid regurgitation after successful mitral valve replacement for rheumatic mitral valve disease. British Heart Journal 66(4): 295-301, 1991

Mitral valve stenosis and pure tricuspid valve regurgitation comparison of necropsy patients having simultaneous mitral and tricuspid valve replacements with necropsy patients having simultaneous mitral valve replacement and tricuspid valve anuloplasty. American Journal of Cardiology 58(9): 768-780, 1986

Role of tricuspid valve repair for moderate tricuspid regurgitation during minimally invasive mitral valve surgery. Thoracic and Cardiovascular Surgeon 61(5): 386-391, 2013

Evidence of tricuspid valve remodeling in patients with severe mitral regurgitation independently of degree of functional tricuspid regurgitation: a two- and three-dimensional echocardiographic study. Journal of Heart Valve Disease 23(2): 200-208, 2014