Management of functional tricuspid regurge during mitral valve replacement, DeVega versus Bicuspidization repair.

Background: Rheumatic mitral valve disease (stenosis or regurgitation) is mostly associated with secondary (functional) tricuspid valve regurgitation due to tricuspid annular dilatation that needs to be repaired (during mitral valve replacement) through annular reduction. Many methods of tricuspid repair have been reported (ring annuloplasty, DeVega, bicuspidization & other methods). Aim of the work: In this retrospective study, we compared the early & 6 months follow up results after repair of functional tricuspid regurgitation in cases of rheumatic mitral valve replacement through two methods, DeVega versus bicuspidization repair. Patients and methods: The study has 40 patients who underwent mitral valve replacement (rheumatic) associated with moderate to severe functional tricuspid regurgitation. The study divided them into two groups, each with 20 patients . The first group underwent tricuspid repair through the De-Vega method . The other group underwent tricuspid repair through the (Bicuspidization) method. We compared the early results (6 months follow-up) of both groups. Results: Both groups showed improvement in functional status at six months follow-up compared to preoperative NYHA classification. Echocardiographic evaluation in the segmental repair group demonstrated marked improvement in tricuspid valve function and pulmonary artery pressure. Conclusion: Both procedures resulted in marked improvement in tricuspid valve function, reduction of pulmonary artery pressure, and restoration of functional capacity. Early postoperative recovery was smooth and comparable between the two groups, with low rates of complications and no significant differences in ICU or hospital stay. Bicuspidization repair showed a greater functional improvement in some patients.