Impact of Tricuspid Valve Repair on Less Than Moderate Tricuspid Regurgitation After Degenerative Mitral Repair

BACKGROUND: Whether tricuspid valve (TV) repair should be performed during degenerative mitral valve repair in patients with less than moderate regurgitation remains controversial. OBJECTIVES: This study aimed to explore the clinical outcomes of degenerative mitral valve repair for less than moderate tricuspid regurgitation (TR). METHODS: Between 2010 and 2019, 541 patients with less than moderate TR underwent mitral valve repair for degenerative mitral disease at the Beijing Anzhen Hospital. Among these patients, 255 underwent concomitant TV repair. The median follow-up was 8 years (Q1-Q3: 6-11 years). The primary endpoint was the development of moderate TR. The secondary endpoint was death, recurrent mitral regurgitation (MR), reoperation for MR or TR, new-onset atrial fibrillation, and permanent pacemaker implantation. Propensity score matching was performed to reduce selection bias. RESULTS: After baseline adjustment, propensity score matching analysis identified 207 pairs. There were no significant differences in the primary endpoints between the patients who underwent simultaneous TV repair and those who did not. Mortality, recurrent MR, permanent pacemaker implantation, and reoperation for MR or TR did not differ significantly between groups. Concomitant TV repair only contributed to new-onset atrial fibrillation, with 24 (11.6%) in the TV-repair group and 7 (3.4%) in the no-repair group (P = 0.001). CONCLUSIONS: Considering its minimal effects on the development of TR and potential contributions to postoperative new-onset atrial fibrillation during follow-up among these patients, more aggressive TV repair is not encouraged among patients with less than moderate TR during MV surgery.