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Evolution of Repaired and Non-repaired Tricuspid Regurgitation in Rheumatic Mitral Valve Surgery without Severe Pulmonary Hypertension

Kaan Kirali, MD, Suat Nail Ömerolu, MD, Kemal Uzun, MD, Vedat Erentu, MD, Nilgün Bozbua, MD, Ercan Eren, MD, Mehmet Balkanay, MD, Mete Alp, MD, Cevat Yakut, MD

Department of Cardiovascular Surgery, Ko!uyolu Heart and Research Hospital, Istanbul, Turkey

For reprint information contact: Kaan Kirali, MD Tel: 90 216 326 6969 Fax: 90 216 339 0441 Email: imkkirali{at}yahoo.com Department of Cardiovascular Surgery, Ko#uyolu Heart and Research Hospital, Kadiköy 81020, Istanbul, Turkey.

The aim of this study was to evaluate the usefulness of repairing significant tricuspid regurgitation ( grade 2) without severe pulmonary hypertension ( 50 mm Hg). Between 1993 and June 2001, 88 consecutive patients were operated on for rheumatic mitral valve disease associated with significant tricuspid regurgitation and without severe pulmonary hypertension. The severity of the tricuspid valve disease was assessed by echocardiography. Sixty-three patients had severe ( grade 3) tricuspid regurgitation (Group I), and 25 patients had moderate (grade 2) tricuspid regurgitation (Group II). There was no hospital mortality. six patients died during follow-up. The overall actuarial survival rate for 8 years was 92.1% ± 3.1%. Cox proportional hazard regression analysis showed that age ( p = 0.006) and pulmonary complication ( p = 0.01) were associated with increased late mortality. Freedom from death was similar in both groups at 8 years (93.1% ± 3.3% versus 88% ± 8%, p = 0.7). Severe postoperative tricuspid regurgitation ( grade 3), caused by the failure of tricuspid repair or leaving the valve untouched, impaired long-term survival after surgery, and actuarial survival was 96.1% ± 2.7% and 83% ± 7.8% at 7 years ( p = 0.048), respectively. Severe tricuspid regurgitation, functional or organic, should be corrected at the time of mitral valve surgery, whereas untouched functional moderate tricuspid regurgitation improves after mitral valve surgery.

This article has been cited by other articles:

				J. M. Bernal, D. Morales, C. Revuelta, J. Llorca, J. Gutierrez-Morlote, and J. M. Revuelta Reoperations after tricuspid valve repair J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 498 - 503. [Abstract] [Full Text] [PDF]