Key points are not available for this paper at this time.
OBJECTIVE: To assess the evolution of tricuspid regurgitation (TR) in dilated cardiomyopathy (DCM) patients submitted to mitral repair for functional mitral regurgitation (MR). METHODS: Ninety-one DCM patients (mean age 61+/-11.3) submitted to MV repair (+/-tricuspid repair) for functional MR were included. Preoperative EF was 30.9+/-6.5%, left ventricular (LV) end-diastolic volume 113+/-31.5 ml/m(2), LV end-systolic volume 81.8+/-26.7 ml/m(2), functional MR > or =3+/4+. TR was classified as or =3+/4+ in 13 (14.2%). Most of the patients were in NYHA class III or IV. A tricuspid annuloplasty was associated to mitral repair whenever preoperative TR was > or =3+. Therefore 13 patients (14.2%) underwent concomitant tricuspid annuloplasty whereas the remaining 78 (with preoperative TR or =3+ was 78+/-8.8% at 3.5 years. Among the 78 patients not submitted to tricuspid repair, 14 (18%) showed a progression of TR severity equal or greater than two grades. The multivariate analysis identified grade of TR at discharge (OR 5.4, p=0.01) and preoperative RV dysfunction (OR 19.6, p=0.02) as the only independent predictors of TR > or =3+/4+ at follow-up. CONCLUSIONS: A significant number of patients submitted to mitral repair for functional MR present > or =3+ TR at follow-up as consequence of progression of untreated TR or failure of tricuspid repair. A more aggressive and effective treatment of functional TR in this setting should be pursued.
Bonis et al. (Thu,) studied this question.