Letter by Fayssoil Regarding Article, “Determinants of Surgical Outcome in Patients With Isolated Tricuspid Regurgitation”
To the Editor:
I read with great interest the article by Kim et al1 about the identification of preoperative predictors of clinical outcomes after surgery in patients with severe tricuspid regurgitation. This article raised the concerns stated below.
Tricuspid annular dilatation is an important factor in the development of late tricuspid regurgitation.2 The mean tricuspid annular diameter was 44+/–8 mm in this study. A long follow-up would be interesting to assess late tricuspid regurgitation in patients who benefited from tricuspid valve repair.
Because surgical techniques may influence the outcome of patients, which method was used for the repair of the tricuspid valve? What was the outcome of patients with tricuspid repair versus tricuspid valve replacement?
Fifty-three patients underwent tricuspid valve replacement with the use of tissue valves (n=30) or mechanical valves (n=23). Because the bioprosthetic valve is preferred over the mechanical valve, what was the outcome of patients with tricuspid bioprosthetic valve versus tricuspid mechanical valve? Because a complete heart block may be a complication of tricuspid valve replacement,3 did the authors have data about this complication?
Anemia may affect the gradient of valve prosthesis. Did the authors correlate the tricuspid mean transvalvular gradient assessment with hemoglobin? Did the parameter affect the outcome?