Surgical treatment of late tricuspid regurgitation after left cardiac valve replacement

  AIM  To investigate postoperative results of late tricuspid regurgitation (TR) after left cardiac valve replacement.

  METHODS  The present investigation retrospectively reviewed 42 patients with a history of left-sided valve operations who underwent tricuspid procedures from Jan 2007 to Jan 2017.

  RESULTS  The mean age of the 42 patients (e.g., 11 men and 31 women) was 52±11 years with an age range of 30 to 66 years. The mean time from last surgery was 11±4 years with a range of 1 to 19 years. Mitral perivalvular leakage or aortic perivalvular leakage was found in 24 patients. Surgical technique included tricuspid valve repair in 31 patients, while 11 patients underwent tricuspid valve replacement (e.g., 3 bioprosthetic valve prostheses, 8 mechanical valve prostheses). The early mortality rate was 14% (6 of 42 patients; 2 repairs, 4 replacements). Follow-up was complete in 37 patients (88%) with a median follow-up of 73±31 months (IQR 6~120 months). Amongst patients who underwent tricuspid valve repair, 22 had none-to-mild tricuspid regurgitation and 4 had moderate-to-severe tricuspid regurgitation.

  CONCLUSION  Tricuspid valve procedures after left-sided valve operations in rheumatic patients can have good clinical outcomes. The management of left ventricular dysfunction before the operation plays an important role in the entire process. Proper selection of surgery is critical for success.