Clinical outcomes and analysis of right ventricular function and geometry in patients undergoing tricuspid annuloplasty in addition to mitral valve surgery during complex left-sided heart surgery

Abstract

Guidelines from the ESC, AHA and ACC state that tricuspid valve annuloplasty (TVP) needs to be performed during left-sided surgery in case of tricuspid annular dilatation or functional TR. However, though progression of functional TR might be prevalent after left-sided surgery, data on applying TVP guidelines, with regards to clinical outcomes and their relation to preoperative echocardiographic findings together with right ventricular (RV) function and geometry analysis, in more complex left-sided heart surgery, are unknown.

We hypothesize that more adverse events are expected in patients undergoing tricuspid annuloplasty in addition to complex left-sided heart surgery, associated with a worse prognostic value of the EuroSCORE® together with several predictive echocardiographic parameters. This in conjunction with reverse RV remodeling but associated with function deterioration after TVP, being more pronounced in patients undergoing TVP because of severe coexisting TR.