ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The factors associated with progression of tricuspid regurgitation after left-sided double valve replacement in propensity score matched analysis
Rezan Aksoy1, Ali Karagöz2, Deniz Çevirme1, Mehmet Dedemoğlu3, Hakan Hancer1, Alev Kılıçgedik2, Murat Bülent Rabus1
1Department of Cardiovascular Surgery, Koşuyolu High Specialization Education and Research Hospital, Istanbul, Türkiye
2Department of Cardiology, Koşuyolu High Specialization Education and Research Hospital, Istanbul, Türkiye
3Pediatric Heart Surgery Ümraniye Training and Research Hospital, Istanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2022.22553
Background: This study aims to investigate the association of progression of tricuspid regurgitation following double-valve replacement by comparing the tricuspid valve repair and no repair groups, and to analyze outcomes of patients with non-repaired mild-to-moderate tricuspid regurgitation.

Methods: Between January 2014 and September 2017, a total of 157 patients (74 males, 83 females; mean age: 51.7±13.7 years; range, 18 to 78 years) who underwent aortic and mitral valve replacements with/without concomitant tricuspid valve repair were retrospectively analyzed. The patients were divided into two groups: no-repair (n=78) and repair groups (n=79). The primary outcome measure was development of more than moderate tricuspid regurgitation during follow-up.

Results: The data were evaluated according to propensity score matched analysis. The progression of tricuspid regurgitation was significantly increased in the no-repair group (p=0.006). Rheumatic etiology was independently associated with the presence of postoperative moderateto- severe tricuspid regurgitation (p=0.004, odds ratio: 3.40). There was no statistically significant difference between the groups in terms of the potential complications and mortality and survival rates. A multivariable subgroup analysis for the baseline mild-to-moderate tricuspid regurgitation without repair showed that rheumatic etiology was an independent factor for the progression of postoperative tricuspid regurgitation (p=0.01).

Conclusion: Our study results demonstrated that rheumatic etiology was an independent marker for increased tricuspid regurgitation and it was also independently associated with increased tricuspid regurgitation in patients with mild-to-moderate non-repaired patients. The degree of tricuspid regurgitation was improved in the repair group during follow-up.

Keywords : Aortic valve, mitral valve, tricuspid valve regurgitation, tricuspid valve
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