Concomitant tricuspid annuloplasty and MV repair is safe and effective

For patients undergoing mitral valve (MV) repair, concomitant tricuspid annuloplasty was safe and effective and minimized the risk of tricuspid regurgitation, according to a retrospective analysis. The same surgeon performed MV repair on all of the patients between 2003 and 2011 at Mount Sinai Medical Center in New York.

Lead researcher Joanna Chikwe, MD, of the Department of Cardiovascular Surgery at the Icahn School of Medicine at Mount Sinai, and colleagues published their findings online in the Journal of the American College of Cardiology on April 27.

The 645 patients evaluated all had mitral regurgitation secondary to degenerative disease. The researchers defined degenerative disease as Carpentier type II mitral regurgitation resulting from chordal elongation or chordal rupture with excess leaflet motion.

Of the patients, 65 percent underwent concomitant tricuspid annuloplasty for moderate tricuspid regurgitation and/or tricuspid annular dilation. Patients who underwent tricuspid valve repair were older and had worse right and left ventricular function compared with a group undergoing isolated MV repair.

There was no significant difference between the groups in 30-day mortality, morbidity or permanent pacemaker requirement. Three patients died in the hospital following the procedure, while another patient died of unknown causes two weeks after discharge.

Patients with worse baseline risk factors who underwent tricuspid valve repair had superior freedom from tricuspid regurgitation and improved right ventricular function and pulmonary artery hypertension compared with patients in the MV repair alone group.