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Arch Iran Med. 2019;22(10): 560-565.
  Abstract View: 138
  PDF Download: 142

Original Article

Effect of Tricuspid Valve Repair in Patients with Moderate Tricuspid Regurgitation undergoing Left-Sided Valve Surgery

Fahime Abdollahi 1, Masoumeh Lotfi-Tokaldany 1, Arash Jalali 1, Mohammad Moein Ashrafi 2 ORCID logo, Abbas Mohagheghi 3, Afsaneh Sadeghian 4, Hakimeh Sadeghian 3 *

1 Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
2 Young Researchers and Elites Club, Faculty of Medicine, Islamic Azad University, Yazd Branch, Yazd, Iran
3 Echocardiography Department, Dr. Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
4 Bahar Hospital, Shahrood University of Medical Science, Shahrood, Iran

Abstract

Background: The benefits of tricuspid valve (TV) repair in patients with moderate tricuspid regurgitation (TR) during left-sided valve surgery are under debate. We investigated independent predictors for reduction in TR severity following left-sided valve surgery in patients with moderate TR.

Methods: In this study, we included 106 patients (male: 33%) with a mean age of 4.23 ± 12.61 years who had moderate TR and underwent mitral or aortic valve surgery between March 2012 and November 2016. Concomitant tricuspid annuloplasty was done for one group of patients based on surgeon’s decision. Transthoracic echocardiography was done before and at a median followup of 4.71 months for all patients. The patients were divided into improved and unimproved TR groups, with the term “improved” signifying a reduction of at least one grade in TR severity.

Results: Tricuspid annuloplasty was performed on 65 (61.3%) patients. TR improvement was observed in 87.7% of patients in the TV repair group and 56.1% of patients in the no-TV repair group, indicating a significant difference (P < 0.001). Tricuspid annulus diameter was not significantly different between the two groups (32.41 ± 4.68 mm in no-TV repair group and 33.87 ± 4.34 mm in TV repair group, P = 0.128). At follow-up with echocardiography, 80 (75.5%) patients were placed in the improved group and the majority of patients (71.3% vs. 30.8%; P < 0.001) underwent tricuspid repair in the improved group. TV annuloplasty was correlated with reduced TR severity following left-sided valve surgery (odds ratio [OR]: 5.19, 95% CI: 1.70–15.85, P < 0.001). TR changed from moderate to severe in 17 (17.1%) patients with no concomitant tricuspid repair, while only one patient (1.5%) with tricuspid repair showed an increased TR severity.

Conclusion: Tricuspid annuloplasty may be useful in patients who have moderate TR undergoing left-sided valve surgery regardless of the tricuspid annulus diameter, and it can play an effective role in the improvement of TR at mid-term follow-up.

Keywords: Left-sided valve surgery, Tricuspid annulus diameter, Tricuspid regurgitation, Tricuspid valve repair
Cite this article as: Abdollahi F, Lotfi-Tokaldany M, Jalali A, Ashrafi MM, Mohagheghi A, Sadeghian A, et al. Effect of tricuspid valve repair in patients with moderate tricuspid regurgitation undergoing left-sided valve surgery. Arch Iran Med. 2019;22(10):560–565.
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Abstract View: 138

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Submitted: 28 Dec 2018
Accepted: 12 May 2019
ePublished: 01 Oct 2019
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