The Factors Affecting Long Term Tricuspid Regurgitation After Double
Background: This study aims to determine the hemodynamic performance of
double valve prostheses and its effects on long term outcomes of
tricuspid regurgitation(TR) following double valve replacement (DVR).
Methods: Between January 2014- September 2017, all patients undergoing
concomitant aortic and mitral valve replacement with or without
concomitant tricuspid valve repair at the same center were reviewed. All
patients were divided into three groups according to interventions
tricuspid valve(TVI), that is no-tricuspid annuloplasty(TAP), tricuspid
ring annuloplasty and tricuspid de-vega annuloplasty (TDVA).Results: The
study included 179 patients, of whom 52% were women(with mean age
51.7±13.7 years). Of 179 patients, 100 were in the no-TAP group, 39 were
in the ring annuloplasty group and 40 were in the TDVA group. There was
no statically significant difference among the groups with regard to
potential complications, in-hospital mortality and the survival rates.
The degree of TR decreased with TVI. The rates of moderate and severe TR
were significantly lower in in the ring annuloplasty group (P = 0.04 and
0.004). Female gender (OR = 4.0, 95%CI: 1.0-15.5, p = 0.05) and
preoperative TR degree(OR = 2.9, 95%CI: 1.1-7.3, p = 0.01) were an
independent predictors for the development of postoperative severe TR.
Conclusion: Although the degree of postoperative TR varies according to
whether to perform a TVI, DVR can be safe due to low operative mortality
independently from TVI. The rates of moderate and severe TR were
significantly lower in the ring annuloplasty group and female gender was
an independent risk factor of TR progression.