Mild to moderate functional tricuspid regurgitation: Retrospective comparison of surgical and conservative treatment

Background. Unoperated severe tricuspid regurgitation (TR) leads to the right ventricle (RV) failure. We wanted to determine if there was near-term postoperative progression of noncorrected mild to moderate functional TR in patients who underwent mitral valve surgery for chronic significant mitral regurgitation (MR) and if RV size and function were affected. Methods and Results. We compared two groups of patients retrospectively. In the first group (TVA+, n=45), tricuspid valve annuloplasty (TVA) had been performed in conjunction with either mitral valve replacement (MVR) or mitral valve repair (MVP). The second group (TVA, n=22) underwent MVP or MVR without TVA. TVA+ group revealed a significant decrease in TR and right ventricle diameter. In the TVA group, 7 patients (32) showed a significant progression, by one or more grades, of noncorrected TR together with dilatation and decreased ejection fraction of the right ventricle. Conclusions. Tricuspid annuloplasty performed concurrently with MVP or MVR can prevent subsequent progression of tricuspid regurgitation along with right ventricular dilatation and systolic dysfunction in the near-term postoperative period.