Key result
Mitral valve replacement was associated with a higher incidence of Grade 1+ tricuspid regurgitation at 24 months compared to mitral valve repair.
Why the study?
Functional tricuspid regurgitation is common during mitral valve surgery, but whether mitral valve repair or replacement influences the likelihood of late tricuspid regurgitation progression remains unclear.
Does mitral valve replacement compared to mitral valve repair increase the progression of functional tricuspid regurgitation in patients with degenerative mitral valve disease?
Cohort (n=193)
Yes
Does mitral valve replacement compared to mitral valve repair increase the progression of functional tricuspid regurgitation in patients with degenerative mitral valve disease?
Mitral valve replacement, compared to repair, is an independent risk factor for the late progression of functional tricuspid regurgitation in patients with degenerative mitral valve disease.
Answers are grounded in this paper and cite their sources.
MVR was associated with greater late TR progression than MVr; leaves open whether valve strategy affects outcomes in prospective trials.
BACKGROUND: Function tricuspid regurgitation (TR) is frequently observed in patients undergoing mitral valve surgery. It is unclear that mitral valve repair (MVr) or mitral valve replacement (MVR) has influence on the likelihood of late TR progression. METHODS: This study included 193 patients with degenerative mitral valve disease who underwent either MVr or MVR. Detailed preoperative materials, follow-up information, and echocardiographic data were collected and statistically analyzed. RESULTS: At 6 and 12 months postoperatively, MVR patients were more likely to have New York Heart Association (NYHA) class III or IV symptoms than MVr patients (6 mo: 15.2% vs 5.0%, 12 mo: 13.0% vs 4.0%, both P <0.05). At 24 months, the incidence of Grade 1+ TR was significantly higher in MVR patients than MVr patients (25.0% vs 12.9%, P <0.05). In univariate analysis, age (odds ratio [OR] = 1.036, P = 0.036), MVR (OR = 2.256, P = 0.033), and preoperative TR area (TRA; OR = 1.541, P = 0.047) were significant predictors for TR progression. In multivariate logistics analysis, only MVR was independently risk factor (P = 0.006). Subsequently, patients were divided into tricuspid valve repair (TVr) group and untreated group. In both subgroups, MVR patients were associated with significantly larger TRA (P <0.01). CONCLUSION: MVR was an independent risk factor for TR progression, whether tricuspid valve was treated or not.
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Gao et al. (2019) conducted a cohort in Degenerative mitral valve disease with preoperative no to trivial functional tricuspid regurgitation (n=193). Mitral valve replacement (MVR) vs. Mitral valve repair (MVr) was evaluated on Incidence of Grade 1+ tricuspid regurgitation at 24 months (OR 2.256, 95% CI 1.066-4.775, p=0.033). Mitral valve replacement was associated with a higher incidence of Grade 1+ tricuspid regurgitation at 24 months compared to mitral valve repair.
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