Progression of Tricuspid Regurgitation Early After Isolated Mitral Valve Repair

Abstract

Objective: Although some parameters have been defined for predicting late-onset tricuspid regurgitation (TR) after mitral valve (MV) repair, few studies have focused on the early TR progression. The aim of this study was to evaluate the changes in unrepaired TR early after isolated MV repair for degenerative MR, and investigate the predictors of TR progression. Methods:We retrospectively identified 236 patients who underwent isolated MV repair in our institute between 2014 and 2019.Patients with severe preoperative TR, non-degenerative etiology, without echocardiography reports were excluded from the study. Early TR progression was defined as an increase in TR of at least one grade on pre-discharge echocardiography compared to preoperatively. Baseline characteristics were compared between patients with and without early TR progression. Results: A total of 214 patients were analyzed. Mean age was 59 years and 32.7% were female. At baseline, 77.6% had no TR, 20.6% had mild TR, and 1.9% had moderate TR. At follow-up before discharge, 15.4% (n = 33) had TR progression. The TR progression group was older and showed lower body mass index (BMI) than the no-TR progression group. Although not significant, renal function tended to be lower in the TR progression group than in the no-TR progression group. Multivariable analysis revealed higher age and lower BMI as independent predictors of TR progression early after MV repair.Conclusions: Despite appropriate surgical correction of degenerative MR, progression of TR early after MV repair was observed in 15% of the patients. High age and low BMI were independently associated with TR progression early after MV repair.Further studies are necessary to examine the significance of early TR progression on long-term prognosis after MV repair.