Tricuspid valve disease is a leading cause of reoperation after correction of left heart valve defects. The aim of this study was to determine the predictive factors of tricuspid valve regurgitation (TR) progression after surgical treatment of left heart disease.
Methods
It is a retrospective study, including 32 patients, all operated initially for left valve diseases with minimal TR requiring no action on it, between 1995 and 2013 (group 1). These patients have developed during their follow-up a severe TR requiring a correction of the valvular defect. They were compared to a control group with the same characteristics but with stable minimal TR (group 2).
Results
Mean age was 48,5± 8,5 48.5 in group 1 vs 48,22±7,8 years-old in group 2 with a female predominance 78.1% (group1) vs 40,6% (group 2). Predictive clinical preoperative factors of TR progression were female gender (p=0.02) and atrial fibrillation (AF) (p=0.007) on multivariate analysis.
On univariate analysis, predictive preoperative echocardiographic factors of TR progression were pulmonary systemic pressure (PSP) and right ventricular (RV) dilatation (p=0.004). Left atrial (LA) dilatation was found as a predictive factor of TR progression on multivariate analysis (p<0.0001). Postoperative clinical and echocardiographic parameters identified as predictive of TR progression on univariate analysis were left ventricle ejection fraction, Tei index, LA dilatation, TAPSE, RV diameter, tricuspid annulus size, vena contracta and PSP (p<0.001). Female gender, AF and LA dilatation were found as predictive factors of TR progression on multivariate analysis.
Conclusion
The indication for more aggressive interventions for low-grade TR in the left valve surgery should be reserved for female patients, dilated LA and AF.
The author hereby declares no conflict of interest
