Volume 37, Issue 4 pp. 739-746

ORIGINAL ARTICLE

The influence of mitral valve pathology on the concomitant tricuspid valve repair

Amr A. Arafat MD,

Corresponding Author

Amr A. Arafat MD

[email protected]

orcid.org/0000-0003-0951-7287

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt

Correspondence

Amr A. Arafat, MD, Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Bldg 6, Makkah Al Mukarramah Branch Rd, As Sulimaniyah, Riyadh 12233, Saudi Arabia.

Email: [email protected]

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Juan Alfonso RN,

Juan Alfonso RN

Clinical Research Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

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Essam Hassan MD,

Essam Hassan MD

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt

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Claudio Pragliola MD,

Claudio Pragliola MD

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

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Adam I. Adam MD,

Adam I. Adam MD

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

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Khaled D. Algarni MD,

Khaled D. Algarni MD

orcid.org/0000-0001-9903-6078

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

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Amr A. Arafat MD,

Corresponding Author

Amr A. Arafat MD

[email protected]

orcid.org/0000-0003-0951-7287

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt

Correspondence

Amr A. Arafat, MD, Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Bldg 6, Makkah Al Mukarramah Branch Rd, As Sulimaniyah, Riyadh 12233, Saudi Arabia.

Email: [email protected]

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Juan Alfonso RN,

Juan Alfonso RN

Clinical Research Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

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Essam Hassan MD,

Essam Hassan MD

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt

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Claudio Pragliola MD,

Claudio Pragliola MD

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

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Adam I. Adam MD,

Adam I. Adam MD

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

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Khaled D. Algarni MD,

Khaled D. Algarni MD

orcid.org/0000-0001-9903-6078

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia

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First published: 20 January 2022

https://doi.org/10.1111/jocs.16250

Citations: 4

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Abstract

Background

The influence of the etiology of mitral valve (MV) lesion on outcomes of concomitant repair for functional tricuspid regurgitation (TR) is not well studied. Our objectives were to compare long-term survival and TR recurrence after tricuspid valve (TV) repair concomitant with surgery for rheumatic versus degenerative MV disease.

Methods

We included 480 patients who had concomitant MV and TV surgery from 2009 to 2019. We grouped the patients into Group 1 (n = 345; rheumatic MV) and Group 2 (n = 135; degenerative MV). Propensity score matching identified 104 matched pairs.

Results

There was no significant difference in survival between groups before (p = .46) or after matching (p = .09). There was no difference in the recurrence of moderate TR (subdistributional hazard ratio [SHR]: 1.22 [0.77−1.95], p = .40). Recurrent TR was significantly associated with the preoperative TR grade (SHR: 1.8 [1.5−2.16], p < .001); body mass index (SHR: 1.05 [1.03−1.08], p < .001), and the use of flexible versus rigid TV prosthesis (SHR: 0.64 [0.41−0.99], p = .042). Recurrence of TR was higher with MV replacement compared with repair (SHR: 1.69 [1.03−2.78], p = .038). The change in the degree of TR did not differ between groups before matching (OR: 0.77 [0.56−1.04], p = .09) or after matching (OR: 0.98 [0.67−1.44]; p = .93).

Conclusion

Outcomes of concomitant TR repair were comparable in rheumatic and degenerative mitral pathology. Type of the TV prosthesis and TR grade affected TR recurrence. MV repair could be associated with a lower recurrence of TR compared with replacement.

CONFLICT OF INTERESTS

The authors declare that there are no conflict of interests.

Supporting Information

Filename	Description
jocs16250-sup-0001-figure_1_appendix.tif3 MB	Figure 1-appendix: Propensity score distribution.
jocs16250-sup-0002-figure_2_appendix.tif3.1 MB	Figure 2 appendix: Standardized bias across covariates before and after matching (AF: atrial fibrillation; AVR: aortic valve replacement; BMI: body mass index; EDD: end-diastolic diameter; ESD: end-systolic diameter; PASP: pulmonary artery systolic pressure; RV: right ventricle; TR: tricuspid regurgitation; TV: tricuspid valve).
jocs16250-sup-0003-figure_3A_appendix.tif3.1 MB	Figure 3-appendix: Kaplan Meier freedom from moderate or higher tricuspid regurgitation in the unmatched groups (A) and the matched groups (B). Group 1: Rheumatic mitral valve; Group 2: degenerative mitral valve.
jocs16250-sup-0004-figure_3B_appendix.tif3.1 MB	Supporting information.
jocs16250-sup-0005-figure_4A_appendix.tif3.1 MB	Figure 4-appendix: The cumulative incidence of moderate or higher tricuspid regurgitation (TR) stratified by mitral valve (MV) surgery in the unmatched groups (A) and the matched groups (B). Group 1: Rheumatic mitral valve; Group 2: degenerative mitral valve.
jocs16250-sup-0006-figure_4B_appendix.tif3.1 MB	Supporting information.
jocs16250-sup-0007-figure_5A_appendix.tif3.1 MB	Figure 5-appendix: Kaplan Meier freedom from tricuspid valve reoperation in the unmatched groups (A) and the matched groups (B). Group 1: Rheumatic mitral valve; Group 2: degenerative mitral valve.
jocs16250-sup-0008-figure_5B_appendix.tif3.1 MB	Supporting information.
jocs16250-sup-0009-figure_6A_appendix.jpeg25.9 KB	Figure 6-appendix: The change in the degree of tricuspid regurgitation (TR) in the unmatched groups (A) and the matched groups (B). Group 1: Rheumatic mitral valve; Group 2: degenerative mitral valve.
jocs16250-sup-0010-figure_6B_appendix.jpeg28.7 KB	Supporting information.

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

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The influence of mitral valve pathology on the concomitant tricuspid valve repair

Abstract

Background

Methods

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Conclusion

CONFLICT OF INTERESTS

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The influence of mitral valve pathology on the concomitant tricuspid valve repair

Abstract

Background

Methods

Results

Conclusion

CONFLICT OF INTERESTS

Supporting Information

REFERENCES

Citing Literature

References

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