The risk factors of the early postoperative residual tricuspid regurgitation after concomitant thoracoscopic tricuspid valve repair

OBJECTIVE: Secondary tricuspid regurgitation will be aggravated if left uncorrected during the initial surgery. Recently, an aggressive strategy of routine concomitant tricuspid valve repair has been warranted. Follow this strategy, routine concomitant thoracoscopic tricuspid valve repair was performed and the surgical effect and postoperative residual TR were reviewed. METHODS: A two-center, retrospective, observational study was conducted. Patients who underwent concomitant thoracoscopic tricuspid valve repair performed by the same surgeon between May 2012 to April 2020 were recruited into the study. The data were collected from the hospital database and outpatient records from the most recent follow-up to analysis. RESULTS: There were 504 patients recruited in this study. No death occurred and all patients were discharged. The average follow-up time was 7.4 ± 7.5 months. After the surgery, the dimension of right ventricle and pulmonary artery systolic pressure were reduced significantly. There were 11 cases (2.2%) of postoperative residual tricuspid regurgitation. Multiple logistic regression analysis revealed left atrial dimension (p = .002) and tricuspid regurgitation (p = .002) positively associated with the residual tricuspid regurgitation occurrence rate significantly. Kaplan-Meier analysis indicated the more severe the tricuspid regurgitation, the higher the residual tricuspid regurgitation occurrence rate (p < .05). CONCLUSIONS: The tricuspid valve repair surgery may improve the patients' prognosis effectively if it was performed at the appropriate timing. The larger the left atrial dimension is, or the more severe the tricuspid regurgitation is, the higher the residual tricuspid regurgitation occurrence rate after concomitant thoracoscopic tricuspid valve repair. Our experience has shown that concomitant thoracoscopic tricuspid valve repair is reliable, effective, and safe, which may be beneficial to right heart remodeling in the short to midterm.