Why the study?
Current valvular heart disease guidelines lack clear recommendations on when and how to perform interventions for patients with isolated tricuspid regurgitation after left-sided valve surgery.
This expert consensus provides standardized recommendations for the evaluation and management of isolated tricuspid regurgitation late after left-sided valve surgery, emphasizing early intervention before irreversible right ventricular failure.
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Prompts earlier intervention to avert RV failure in isolated post-left valve TR; extends guidelines with standardized timing and transcatheter options.
Tricuspid regurgitation (TR) may occur late after left-sided valve surgery (LSVS). Isolated tricuspid regurgitation after left-sided valve surgery (iTR-LSVS) refers to isolated TR without significant lesions in the mitral and/or aortic position late after mitral and/or aortic replacement or repair. Severe TR has a negative impact on long-term prognosis and requires surgical or transcatheter treatment. However, there is no clear recommendation on when and how intervention should be performed for patients with iTR-LSVS in the current guidelines for the management of valvular heart disease. The historically high operative mortality may be reduced by current minimally invasive techniques and transcatheter therapy. To further understand iTR-LSVS, standardize the treatment, improve the prognosis, and promote the collaboration, the Chinese Minimally Invasive Cardiovascular Surgery Committee (CMICS) wrote this expert consensus on the management of iTR-LSVS from the aspects of etiology, preoperative evaluation, indications for intervention, surgical treatment, transcatheter therapy, and postoperative management.
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Chen et al. (2023) conducted a review in Isolated tricuspid regurgitation after left-sided valve surgery (iTR-LSVS). Surgical and transcatheter treatment was evaluated. Early surgical correction or transcatheter therapy is recommended for isolated tricuspid regurgitation after left-sided valve surgery before the development of irreversible right ventricular dysfunction.
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