The Exploration Of Surgical Intervention Criteria For Tricuspid Regurgitation During Mitral Valve Replacement

Objective:The aim of our retrospective study was to identify a simple and fast criterion for determining whether tricuspid valve repair (TVP) should be performed in patients undergoing mitral valve replacement (MVR)Methods:We reviewed the records of52patients who underwent MVR with (MVR+TVP group, n=33) or without (MVR group, n=19) TVP from January2007to January2011and completed2years of follow-up. Preoperative and2-year postoperative echocardiographic measurements included right ventricular and atrial diameter, interventricular septum size, tricuspid regurgitation severity, ejection fraction, and pulmonary artery pressure.Results:Patient demographics and clinical characters were similar between two groups. All patients in the MVR groups had minor FTR, whereas all patients in the MVR+TVP groups had moderate or severe FTR. There was a significant difference in FTR severity preoperatively (P<0.001). But, there was no significant difference in TR severity postoperatively(P>0.05). Right atrium and ventricular diameter were significantly decreased postoperatively both in the MVR+TVP and MVR group (P<0.05). Pulmonary artery pressure was significantly decreased postoperatively only in MVR+TVP groups (P<0.05). There was a significant difference in right atrium and ventricular diameter and pulmonary artery pressure preoperatively between two groups (P<0.05).Conclusions:l.Our findings suggest echocardiography may be used as a rapid and simple means of determining which patients require TR repair during mitral valve replacement.2. For functional tricuspid regurgitation, tricuspid annular dilation still is an important criteria for determining the need for surgical treatment of tricuspid regurgitation during mitral valve replacement.3.Our research suggest that surgical intervention for FTR should be considered during mitral valve replacement if any of the following preoperative criteria are met:right atrial transverse diameter>43mm; right ventricular end-diastolic diameter>40mm; pulmonary artery pressure>50mmHg.4. Determining whether TR repair should be performed in patients undergoing mitral valve replacement also need to consider the impact of other factor.