Abstract 17271: Long-Term Follow-Up of Functional Tricuspid Regurgitation after Mitral Valve Repair for Degenerative Mitral Regurgitation
INTRODUCTION: We investigated the long-term post-operative tricuspid regurgitation (TR) grade after mitral valve repair for degenerative mitral regurgitation and clarified the impact of concomitant tricuspid valve (TV) repair on long-term TR control.
METHODS: We retrospectively investigated 654 patients who underwent MV repair for degenerative MR between 1991 and 2010. Pre-operative TR grade was mild or less in 479 (73%), moderate in 125 (19%) and severe in 50 (7.7%). Patients with moderate and severe TR were older, in higher NYHA functional class and had a higher rate of pulmonary hypertension and atrial fibrillation than mild or less TR. One hundred and sixty-two patients (25%) underwent concomitant TV repair (TV-repair group), of which 74% were ring annuloplasty and 26% were suture annuloplasty. Follow-up was complete in 98.9%. Mean follow-up duration was 7.5±4.9 years. Follow-up echocardiography was obtained in 87.4% and routinely performed at 1, 3, 5, 10 and 15-year after operation.
RESULTS: In TV-repair group, preoperative mean TR grade was 1.84, which decreased to 0.59 at discharge. In non-TV-repair group, it also decreased from 0.87 to 0.70. During follow-up period, mean TR grade was low in both groups until 10-year after operation, but increased more in TV-repair group after 10-years. Patients who suffered from progression to severe TR were more symptomatic and had higher incidence of cardiac events than who did not. In TV-repair group, progression to severe TR was only seen in suture annuloplasty. In non-TV-repair group, risk factors for progression to severe TR were pre-operative TR grade and afrial fibrillation.
CONCLUSIONS: Concomitant TV repair with ring annuloplasty is effective to reduce the functional TR associated with degenerative mitral regurgitation. However, long-term follow-up is necessary to determine its durability. Aggressive indication of TV repair would be desirable for preoperative atrial fibrillation.
- © 2012 by American Heart Association, Inc.