Concomitant tricuspid ring annuloplasty during mitral valve replacement significantly reduced severe tricuspid insufficiency compared to isolated MVR (0% vs 12%; p<0.001).
Cohort (n=129)
Does concomitant tricuspid ring annuloplasty prevent tricuspid insufficiency progression and right heart overload in patients undergoing mitral valve replacement?
Performing concomitant tricuspid ring annuloplasty during mitral valve replacement significantly prevents the progression of severe tricuspid insufficiency and helps preserve left ventricular ejection fraction.
Absolute Event Rate: 0% vs 12%
p-value: p=<0.001
Abstract OBJECTIVES Tricuspid regurgitation (TR) is commonly encountered in patients with left-sided valve disease and often progresses postoperatively if left unaddressed. While mitral valve replacement (MVR) alone may improve left heart parameters, concomitant tricuspid ring annuloplasty (TRA) might prevent right-sided deterioration. METHODS This retrospective study analyzed 129 patients undergoing MVR between 2016 and 2019. Patients were divided into two groups: isolated MVR (n = 71) and MVR+TRA (n = 58). Long-term echocardiographic outcomes were compared, including LVDD, LVSD, LVEF, LA diameter, IVS thickness, pulmonary flow rate, PAP, and TI degree. RESULTS Both groups showed regression in left heart dimensions postoperatively; however, left ventricular ejection fraction (LVEF) significantly decreased in the MVR-only group (p 0.001) while it remained stable in the MVR + TRA group (p = 0.598). Severe tricuspid insufficiency occurred in 12 % (95 % CI 5–21 %) of patients undergoing isolated MVR and 0 % (95 % CI 0–6 %) of those undergoing MVR + TRA (p 0.001). The mean difference in the change of pulmonary artery pressure (ΔPAP) between groups was 12.0 mmHg (95 % CI 6.5–17.3, p = 0.002), and both pulmonary artery pressure and left atrial diameter significantly decreased postoperatively in the MVR + TRA group. CONCLUSIONS Performing TRA during MVR surgery offers significant protective effects against TI progression and right heart overload. Even in cases with mild TI but annular dilation, simultaneous TRA may be a rational and beneficial strategy to ensure long-term cardiac stability.
Metin et al. (Tue,) conducted a cohort in Mitral valve disease with tricuspid regurgitation (n=129). Concomitant tricuspid ring annuloplasty (MVR+TRA) vs. Isolated mitral valve replacement (MVR) was evaluated on Severe tricuspid insufficiency (p=<0.001). Concomitant tricuspid ring annuloplasty during mitral valve replacement significantly reduced severe tricuspid insufficiency compared to isolated MVR (0% vs 12%; p<0.001).
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