Interdiscip Cardiovasc Thorac Surg. 2026 Jan 16:ivag011. doi: 10.1093/icvts/ivag011. Online ahead of print.
ABSTRACT
OBJECTIVES: Tricuspid regurgitation (TR) is commonly encountered in patients with left-sided valve disease and often progresses postoperatively if left unaddressed. While mitral valve replacement (MVR) alone may improve left heart parameters, concomitant tricuspid ring annuloplasty (TRA) might prevent right-sided deterioration.
METHODS: This retrospective study analyzed 129 patients undergoing MVR between 2016 and 2019. Patients were divided into two groups: isolated MVR (n = 71) and MVR+TRA (n = 58). Long-term echocardiographic outcomes were compared, including LVDD, LVSD, LVEF, LA diameter, IVS thickness, pulmonary flow rate, PAP, and TI degree.
RESULTS: Both groups showed regression in left heart dimensions postoperatively; however, left ventricular ejection fraction (LVEF) significantly decreased in the MVR-only group (p < 0.001) while it remained stable in the MVR + TRA group (p = 0.598). Severe tricuspid insufficiency occurred in 12 % (95 % CI 5-21 %) of patients undergoing isolated MVR and 0 % (95 % CI 0-6 %) of those undergoing MVR + TRA (p < 0.001). The mean difference in the change of pulmonary artery pressure (ΔPAP) between groups was 12.0 mmHg (95 % CI 6.5-17.3, p = 0.002), and both pulmonary artery pressure and left atrial diameter significantly decreased postoperatively in the MVR + TRA group.
CONCLUSIONS: Performing TRA during MVR surgery offers significant protective effects against TI progression and right heart overload. Even in cases with mild TI but annular dilation, simultaneous TRA may be a rational and beneficial strategy to ensure long-term cardiac stability.
PMID:41546375 | DOI:10.1093/icvts/ivag011