Surgical Repair versus Conservative Treatment for Moderate Functional Tricuspid Regurgitation in Concomitant with Mitral Valve Surgery

Moataz Rezk; Shimaa Moustafa; Nora Singab; Ashraf Elnahas

doi:10.35810/ects.v2i2.123

Moataz Rezk Cardiothoracic Surgery Department, Faculty of medicine, Benha University, Banha, Egypt
Shimaa Moustafa Cardiology Department, Faculty of medicine, Benha University, Banha, Egypt
Nora Singab Cardiothoracic Surgery Department, Faculty of medicine, Benha University, Banha, Egypt
Ashraf Elnahas Cardiothoracic Surgery Department, Faculty of medicine, Benha University, Banha, Egypt

DOI: https://doi.org/10.35810/ects.v2i2.123

Keywords: Functional tricuspid regurgitation, Tricuspid annular dilatation, Tricuspid valve repair

Abstract

Background: Management of moderate functional tricuspid regurgitation (FTR) secondary to left-sided valve lesion is controversial. The objective of this study was to compare the short-term results of surgical repair versus conservative treatment for moderate functional tricuspid regurgitation in concomitant with mitral valve surgery.

Methods: Our study included 60 patients with mitral valve lesion and moderate functional tricuspid regurgitation. Patients were divided into 2 groups; group A included 30 patients whose tricuspid valve disease were managed conservatively, and group B included 30 patients who had tricuspid valve band annuloplasty.

Results: Preoperative clinical and echocardiographic data were comparable between groups. There was no difference regarding mechanical ventilation time (6 .13 ± 3.02 vs. 7.01 ± 4.14 hours; p= 0.291), or intensive care unit stay (51.42 ± 12.1 vs. 52.31 ± 15.32 hours; p=0.614) in group A and B respectively. There was a significant improvement in the degree of tricuspid valve regurgitation in group B early postoperative (moderate tricuspid regurgitation reported in 22 (73.3%) vs. 4 (13.3%); p<0.001) and at 3 months (moderate tricuspid regurgitation 11 (36.7%) vs. 2 (6.7%); p<0.001) and 6 months follow up (moderate tricuspid regurgitation 10 (30%) vs. 2 (6.7%); p<0.001) in group A and B respectively. After 6-months, 20 (66.7%) patients in group A had dyspnea grade I compared to 26 (86.7%) patients in group B; p=0.021.

Conclusion: Although the correction of the left-sided lesion improved the degree of TR in some patients, concomitant repair of the tricuspid valve could produce better improvement in the clinical outcome when compared to the conservative approach.