0552: Predictors of functional tricuspid regurgitation after successful left-sided valve surgery

Abstract

Tricuspid regurgitation (TR) is probably the most common and anticipated complication of left-sided heart valve pathology, especially MV disease. Whether preoperative functional TR will regress or progress after successful left-sided valve surgery is unknown. The aim of this study was to identify the predictors of significant TR after successful left-sided valve surgery. A retrospective analysis was performed on a total of 56 patients who underwent left-sided valve surgery (mitral or mitro-aortic valve surgery). We have excluded patients who had organic TR. All patients had complete clinical examination and echocardiographic studies preoperatively and clinical and echocardiographic follow-up postoperatively. Mean operative age of patients was 49,3±13,7 years with a sex-ratio of 0,8. Tricuspid annuloplasty was associated to left-sided valve surgery in 18 (32%) patients. Postoperatively, significant TR was found in 13 patients (23%) with a mean follow-up of 20,5±33 months. Patients with significant postoperative TR were more often female (83% vs 48%, p=0,03), had more often a previous mitral commissurotomy (58% vs 23%, p=0,02) and showed a higher prevalence of significant preoperative TR (69% vs 42%, p=0,04). Postoperatively, residual pulmonary hypertension (p=0,04), dilatation of left atrium (p=0,02) and dilatation of right cardiac cavities (p=0,01) were significant risk factors for development or progression of TR after surgery. Late onset or progression of functional TR after successful left-sided valve surgery is a significant clinical entity as it displays a great impact on patient prognosis. So, the identification of clinical and echocardio-graphic predictors of late TR allows an adequate screening of patients that will require tricuspid valve repair at the time of initial left-sided valve surgery.