Moderate Secondary Tricuspid Regurgitation: Does It Worth More Time to Conserve?

Background: Concomitant repair of moderate secondary tricuspid regurgitation (STR) during mitral valve surgery is still subject of controverse. This research aims to study the early and mid-term postoperative influence of tricuspid repair on the clinical outcomes and right ventricular functions. Methods: This is a retrospective cohort study of 92 patients with moderate STR who underwent tricuspid valve repair between October 2014 and December 2017, in the cardiothoracic surgery department, Menoufia University Hospital. Patients were assessed clinically and by echocardiography at one month and after 24 months postoperatively for the degree of tricuspid regurgitation (TR), right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: In this study, mean age of patients was 58.33 ± 4.06 years. We had a significant improvement in the grade of TR from preoperative period to follow up data observed at 1-month postoperative and 2-years follow-up (P = 0.0001). After one month postoperatively, no TR was detected in 74 cases (80.4%), and in 71 (84.5%) after two years. Mean right ventricular diameter decreased significantly from 23 ± 3.32 mm preoperatively to 21.9 ± 3 mm at 2-years postoperatively. An increase of TAPSE was from 19.96 ± 3.7 mm preoperatively to 20.3 ± 3.9 mm at 1-month postoperative (p = 0.55) and there was significant increase in late postoperative value. Conclusion: We highly recommend repair for moderate TR during mitral valve surgery to avoid progression of TR. Tricuspid repair was able to reduce the grade of regurgitation after two years of surgery and improved right ventricular functions.