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Overview

Juan A. Crestanello, M.D., is a cardiovascular surgeon and department chair of Cardiovascular Surgery at Mayo Clinic in Rochester, Minnesota. Dr. Crestanello, who specializes in surgery for valvular heart disease, discusses outcomes of tricuspid valve surgery in patients with functional tricuspid regurgitation.

JUAN CRESTANELLO: Welcome to the Cardiovascular Surgery Series where we review the latest research in cardiovascular surgery from the Mayo Clinic in just two minutes. I am Dr. Juan Crestanello. I'm a cardiac surgeon at the Mayo Clinic in Rochester, Minnesota.

We will discuss today the outcomes of tricuspid valve surgery in patients with functional tricuspid regurgitation. This article was published in the European Journal of Cardiothoracic Surgery. Functional tricuspid regurgitation is the most common cause of tricuspid regurgitation. These occur more often secondary to left-sided heart pathology, atrial defibrillation, or pulmonary hypertension.

We reviewed 926 patients who had tricuspid valve surgery for functional TR. 83% of the patients had tricuspid valve repair. Patients who had tricuspid valve replacement had more often severe tricuspid regurgitation and more severe right ventricular dysfunction. Tricuspid valve repair was associated with lower operative mortality and better long-term survival. Risk factors for overall mortality were congestive heart failure, previous mitral valve surgery, and tricuspid valve replacement.

We conclude that tricuspid valve repair had better outcomes than replacement for functional TR. Since previous mitral valve surgery was identified as a risk factor for mortality, concomitant tricuspid repair at the time of mitral valve surgery may improve outcomes. Early surgery before the onset of congestive heart failure may also improve outcomes.

Thank you for listening to the Mayo Clinic Cardiovascular Surgery Series.