Long-Term Impact of Preventive Tricuspid Valve Annuloplasty on Right Ventricular Remodeling
Key result
Preventive tricuspid annuloplasty during mitral surgery is linked to ~0% incidence of significant TR.
- P=0.001
- n=98
Why the study?
The long-term impact on right ventricular adverse remodeling and the benefit of preventive tricuspid valve annuloplasty during left-sided valve surgery remained controversial.
Does concomitant preventive tricuspid valve annuloplasty prevent right ventricular adverse remodeling and significant tricuspid regurgitation in patients with primary mitral regurgitation and tricuspid annulus dilatation undergoing mitral valve repair?
Population
98 patients with primary MR and TV annulus dilatation ≥40 mm without significant TR undergoing MV repair
Comparison
Concomitant TV annuloplasty vs isolated MV repair without TV annuloplasty
Authors
Discussion
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Member takes
Implication
Associated with less late tricuspid regurgitation after mitral repair; leaves open effects on right ventricular remodeling pending randomized trials.
Study Design
Type
Cohort (n=98)
Structured PICO
Does concomitant preventive tricuspid valve annuloplasty prevent right ventricular adverse remodeling and significant tricuspid regurgitation in patients with primary mitral regurgitation and tricuspid annulus dilatation undergoing mitral valve repair?
P
Population
98 patients with significant primary mitral regurgitation (MR) and tricuspid valve (TV) annulus dilatation ≥40 mm without significant tricuspid regurgitation (TR) undergoing mitral valve (MV) repair. Mean age 65 ± 11 years, 85% men.
I
Intervention
Concomitant tricuspid valve (TV) annuloplasty at the time of mitral valve surgery
C
Comparator
Isolated mitral valve repair without tricuspid valve annuloplasty
O
Outcome
Differences in long-term right ventricular (RV) adverse remodeling (RV basal diameter, RV long-axis diameter, RV end-diastolic area, RV end-systolic area) and the development of significant tricuspid regurgitation (TR)surrogate
Main Result
Absolute Event Rate: 0% vs 14%
p-value: p=0.001
Preventive tricuspid valve annuloplasty during mitral valve surgery in patients with a dilated tricuspid annulus prevents long-term right ventricular adverse remodeling and the development of significant tricuspid regurgitation.
Cite This Study
Dietz et al. (2022) conducted a cohort in Primary mitral regurgitation with tricuspid annulus dilatation (n=98). Concomitant tricuspid valve annuloplasty vs. Isolated mitral valve repair without tricuspid valve annuloplasty was evaluated on Development of significant tricuspid regurgitation (p=0.001). Concomitant preventive tricuspid valve annuloplasty during mitral valve surgery prevented the development of significant tricuspid regurgitation compared to no annuloplasty (0% vs 14%, p=0.001).