Approach to concomitant moderate-tosevere TR in patients undergoing mitral valve surgery, should we intervene?

Aim: The aim of this study was to investigate the changes in postoperative tricuspid valve function in patients with preoperative moderate to severe Tricuspid Regurgitation (TR) who underwent tricuspid valve surgery concomitantly with mitral valve surgery according to intraoperative tricuspid valve evaluation.

Material and Methods: The study included 89 patients with moderate-to-severe additional tricuspid valve regurgitation who underwent mitral valve replacement for isolated mitral stenosis, isolated mitral regurgitation, and combined mitral stenosis and regurgitation in our clinic between 2014 and 2021. All patients were divided into two groups; those who underwent mitral valve replacement were divided into Group 1 (n=43) and those who underwent tricuspid valve intervention in addition to mitral valve replacement were divided into Group 2 (n=46).

Results: Median weight and Body Mass Index (BMI) values of Group 2 were significantly higher than Group 1 (p=0.002 and p=0.005). Preoperative Atrial Fibrilation (AF) rate in Group 2 (89.1%) was significantly higher than in Group 1 (46.5%) (p<0.001). The mean Left Atrial Diameter (LAD) in Group 2 (5.17±0.69) was significantly higher than in Group 1 (4.76±0.62). The reduction in the degree of TR was significantly higher in Group 2 (-1 [IQR: -2-0]) than in Group 1 (0 [IQR: -1-0]) (p=0.002).

Conclusion: DeVega annuloplasty, the simplest method, can be applied as a simple and effective method. Therefore, it should be considered as an alternative to other annuloplasties in patients with moderate to severe secondary tricuspid regurgitation.