Prophylactic Tricuspid Annuloplasty During Mitral Valve Surgery

Prophylactic Tricuspid Annuloplasty During Mitral Valve Surgery

Single center randomized study to test whether a prophylactic tricuspid annuloplasty at the time of mitral valve procedure can improve clinical and echocardiographical outcomes.

The optimal management of functional tricuspid regurgitation (FTR) in the setting of mitral valve operations remains controversial. The current practice is both center- and surgeon-specific with guidelines based on non-randomized data. A prospective randomized trial was performed to evaluate the worth of less-than-severe FTR repair during mitral valve procedures.

A single center randomized study was designed to allocate patients with less-than-severe FTR undergoing mitral valve surgery to be prophylactically treated + tricuspid valve annuloplasty (TVP- or TVP+). These patients were analysed using longitudinal cardiopulmonary exercise capacity, echocardiographic follow-up, and cardiac magnetic resonance (CMR). The primary outcome was more than mild tricuspid regurgitation (TR) recurrence with vena contracta >3mm. Secondary outcomes were maximal oxygen uptake (VO2 max) and right ventricular (RV) dimension and function.

Inclusion Criteria:

• patients undergoing mitral valve surgery with less than sever tricuspid insufficiency

Exclusion Criteria:

• presence of pacemaker lead through the tricuspid valve
• acute endocarditis
• minimally invasive approach
• Functional mitral valve insufficiency