Key result
Tricuspid regurgitation is a common condition where moderate to severe disease is an independent risk factor for mortality, and concurrent surgical repair during left heart valve surgery improves heart failure symptoms.
This review highlights that pathologic tricuspid regurgitation is an independent mortality risk factor and that concurrent surgical repair during left heart valve surgery improves symptoms, though survival benefits remain unproven.
May prompt concurrent tricuspid repair during left heart valve surgery to ease symptoms; leaves open randomized confirmation of survival benefit.
Tricuspid regurgitation (TR) is a common finding. Pathologic TR is an independent risk factor for mortality. TR can be classified by etiology into functional versus organic. Organic TR is caused by structural damage to the tricuspid valve (TV) by a spectrum of etiologies, including pacemaker leads and right heart biopsies, whereas functional TR is predominantly due to elevated pulmonary pressures. Atrial fibrillation and chamber enlargement, among other risk factors, are strong predictors of functional TR. Correction of elevated pulmonary pressures improves TR, and concurrent repair of severe TR at the time of left heart valve surgery improves postoperative heart failure symptoms but does not improve survival. TR repair is associated with less operative and long-term mortality than TV replacement, and demonstrates similar improvements in heart failure symptoms. Substantial residual TR remains after repair, and reoperative mortality for residual TR is considerable. Percutaneous TV replacement may offer a rescue strategy.
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Cheng et al. (2015) conducted a review in Tricuspid Regurgitation. Tricuspid valve repair or replacement was evaluated. Tricuspid regurgitation is a common condition where moderate to severe disease is an independent risk factor for mortality, and concurrent surgical repair during left heart valve surgery improves heart failure symptoms.
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