Query in dealing progressive tricuspid regurgitation with mitral valve disease

Abstract

Objective: The recommendation to repair progressive tricuspid regurgitation (TR) at the time of mitral valve (MV) surgery is questionable. We assessed the outcomes of tricuspid valve (TV) repair for progressive TR with MV surgery. Patients and Methods: We assigned 611 patients with progressive TR who had MV replacement with or without concomitant TV repair from January 2015 to December 2016. Results: There were no remarkable variation in early mortality or major morbidity rates according to the etiology of the MV disease. Median follow-up was 36 months. After adjustment for baseline characteristics using a propensity score adjustment model, there were no significant differences in the frequency of re-admission for congestive heart failure between the groups. Both groups had similar risk for other late complications affected by valve surgery such as stroke, significant hemorrhage related to anticoagulation, reoperation due to valvular heart lesions other than TV, or infective endocarditis. However, comparing the severity of TR at the last follow-up, patients with greater than progressive TR were significantly less common in the repair group of mitral regurgitation compared with those in the control group. Conclusions: The clinical benefit of simultaneous TV repair for progressive TR with MV surgery for rheumatic mitral regurgitation is certain. Concomitant TV repair cannot be routinely recommended in patients with rheumatic mitral stenosis at the time of MV repair or replacement.