Mild to Moderate Functional Tricuspid Regurgitation: Retrospective Comparison of Surgical and Conservative Treatment

Abstract

Background. Unoperated severe tricuspid regurgitation (TR) leads to the right ventricle (RV) failure. We wanted to determine if there was near-term postoperative progression of noncorrected mild to moderate functional TR in patients who underwent mitral valve surgery for chronic significant mitral regurgitation (MR) and if RV size and function were affected. Methods and Results. We compared two groups of patients retrospectively. In the first group (TVA+, n = 45), tricuspid valve annuloplasty (TVA) had been performed in conjunction with either mitral valve replacement (MVR) or mitral valve repair (MVP). The second group (TVA−, n = 22) underwent MVP or MVR without TVA. TVA+ group revealed a significant decrease in TR and right ventricle diameter. In the TVA− group, 7 patients (32%) showed a significant progression, by one or more grades, of noncorrected TR together with dilatation and decreased ejection fraction of the right ventricle. Conclusions. Tricuspid annuloplasty performed concurrently with MVP or MVR can prevent subsequent progression of tricuspid regurgitation along with right ventricular dilatation and systolic dysfunction in the near-term postoperative period.

Maximal Beneficials Foreshows of Adopting De Vega Annuloplasy Technique Addressing Secondary Severe Tricuspid Regurgitation

“…NYHA classification of our cohort showed dramatic improvement at one-year follow-up where no candidate remained in NYHA class III or IV while most of the cohort expressed as 26 (83.87%) became in NYHA class I and the other 5 (16.12%) became in NYHA class II. Again, our results come comparably consistent with the results reported by other investigators [1,9,15,16,20,21] . This obvious observation of improvement of NYHA clinical status may be thus explained based on improved TR degree and right-sided heart failure stigmata.…”

“…This provides a clear proof of the association between the decline in the degree of TR and the upturn in the NYHA class documenting the fact of this inverse relationship. This observation was reported by other researchers [1,9,16,20,21] . Opposing to our conclusion what was stated by Abdelmohty et al [15] .…”

“…Also, Choi et al [16] reported 9/174 (5.17%) had postoperative moderate or severe TR while the rest 165/174 (94.83%) had mild TR. Abdelmohty et al [15] reported a rate of 75.75% freedom of the preoperative severe secondary TR at their 6-months follow-up study and so did Smid et al [20] who reported 77.40-100% freedom rate in their 3-79 months follow-up study. Again, Kara et al [21] reported 77.10-100% freedom of the preoperative severe secondary TR in their 3-64.8 months follow-up series.…”

Application of Percutaneous Balloon Mitral Valvuloplasty in Patients of Rheumatic Heart Disease Mitral Stenosis Combined with Tricuspid Regurgitation

“…[ 3 ] They also reported that significant TR did not substantially decrease or resolve after PBMV in the majority of patient; thus, they thought surgical angioplasty was needed for treatment of tricuspid insufficiency. [ 13 14 15 16 ] However, other investigators (eg., Hannoush et al . and Song et al .)…”

Tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure ratio as a predictor of in-hospital mortality for acute heart failure

“…The severity of tricuspid regurgitation was also evaluated in from the apical four-chamber view and assessed semiquantitatively from the Color Doppler Flow (mild degree: up to 1/3 of the right atrium (RA), moderate degree: 1/3–2/3 of RA, severe degree: 2/3–the full length of RA) [ 28 ].…”