Tricuspid valve replacement after cardiac transplantation

Abstract

Results of tricuspid valve repair in the post-cardiac transplant setting are not ideal, and this strategy is better suited to treating functional tricuspid valve regurgitation resulting from annular dilatation. Tricuspid valve replacement with a bioprosthesis is a safe, durable, and effective method of treating tricuspid valve regurgitation following transplantation and allows for future endomyocardial biopsies to be performed. Mechanical valves should be avoided. A randomized controlled trial examining the long-term outcomes of prophylactic tricuspid annuloplasty is warranted.

Association of Donor Tricuspid Valve Repair With Outcomes After Cardiac Transplantation

“…Functional TR may result from valve apparatus distortion from right heart failure, ischemic injury, rejection, or elevated pulmonary vascular resistance. TR progression to hemodynamic significance leads to clinical right heart failure, sometimes requiring pTVR [5,13]. The only significant variables in our propensity score logistic regression model were transplant year and surgeon, suggesting that dTVR performance at our institution may reflect changes in practice over time and individual surgeon practice.…”