Predictors of Failure after DeVega Repair for Functional Tricuspid Regurgitation

  • Hysam Abdelmohty Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
  • Wael Abdelaziz Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
  • Mohamed-Adel Elanwar Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
  • Ehab Abdelazeem Department of Anesthesia and Intensive Care, Faculty of Medicine, Benha University, Benha, Egypt
  • Mohamed Ali Department of Cardiology, Faculty of Medicine, Benha University, Benha, Egypt
  • Basem Abdelgawad Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Benha, Egypt
Keywords: Functional Tricuspid regurgitation, Tricuspid repair, De Vega annuloplasty, Mitral valve replacement

Abstract

Background: Untreated tricuspid regurgitation during mitral valve surgery may progress to severe symptomatic tricuspid regurgitation. Concomitant repair may increase the operative risk; however, re-operative tricuspid valve surgery is a high-risk procedure. This study's objective was to identify the predictors of DeVega repair failure in patients with functional tricuspid regurgitation and concomitant mitral valve surgery.

Methods: This research is a retrospective comparative study that included 140 patients who underwent tricuspid valve repair concomitant with mitral valve replacement. We divided the patients into two groups; the first group (n=106) included patients with no DeVega failure at six-months follow-up (The sustained repair group). The second group included 34 patients who developed moderate or higher TR after the DeVega and was named the failed repair group.

Results: The demographic data and comorbidities were not statistically different between both groups. The preoperative atrial fibrillation (73 (69%) vs. 30 (88%)’ p= 0.027) pulmonary artery pressure (64.8±3.6 vs. 81±6.5 mmHg; p= 0.02), right ventricular dimension (4.85±0.24 vs. 5.23±0.37 cm; p= 0.03), and time between the indication of surgery and operation (8.3 ± 3.1 vs. 14.7 ± 5.4 months; p = 0.003) were higher in patients with failed DeVega repair. There was no statistically significant difference regarding the mean bypass time, cross-clamp time, ICU and hospital stay, and postoperative complications between both groups. Predictors of failure after six months were preoperative heart failure (OR: 15.4 (95% CI: 3- 92.3); p= 0.003), long time between diagnosis and surgery (OR: 12.3 (95% CI: 2.1- 84.7); p= 0.007), and postoperative severe pulmonary hypertension (OR: 24.7 (95% CI: 3.1- 199.6); p= 0.003).

Conclusions: DeVega repair is associated with a high failure rate after six months. The study of predictors of failure could change our management plans to reach the best results for repair.

Published
2021-05-01
How to Cite
Abdelmohty , H., Abdelaziz , W., Elanwar , M.-A., Abdelazeem , E., Ali , M., & Abdelgawad, B. (2021). Predictors of Failure after DeVega Repair for Functional Tricuspid Regurgitation. The Egyptian Cardiothoracic Surgeon, 3(3), 80 - 87. Retrieved from https://journals.escts.net/ects/article/view/184
Section
Adult cardiac