Functional Tricuspid regurgitation, a common concomitant occurrence in patients with mitral valve disease, typically presents as annular dilatation without valvular pathology. The need for simultaneous surgical annuloplasty is currently recommended based on the tricuspid annulus size and regurgitation gradient. The aim of this study is to evaluate the short and long-term effects of combined tricuspid ring annuloplasty in patients undergoing mitral valve replacement. This study evaluates all patients who underwent Mitral Valve Replacement between January 2023 and December 2023, at a tertiary care specialist centre, for stenotic, regurgitant or combined mitral valve lesions with coexisting tricuspid regurgitation. Patients were compared based on surgical addressing of tricuspid regurgitation. Post-operative outcomes were measured comparing transthoracic ECHOs preoperatively, in the immediate post-operative period, within 10 days of surgery and at 3 months, 6 months and 12 months to assess the degree of Tricuspid regurgitation and its recurrence post annuloplasty or worsening in cases not surgically addressed. There was a notable female preponderance amongst patients who underwent mitral valve replacement. Tricuspid ring annuloplasty was performed in 18% of the study population. Mean age of the sample was 43 years, the majority falling between 41 – 60 years. While initial pre-operative period did not show much variation in outcomes of cases where tricuspid regurgitation was surgically addressed versus not, follow-up showed a gradual worsening in the severity of tricuspid regurgitation without surgical intervention and associated deterioration of cardiac function in a proportion of cases. However, remodelling causing preservation of right heart function was also noted in a fraction of cases. Optimal management of functional tricuspid regurgitation remains controversial with current practices being centre and surgeon specific, however long-term follow-up studies may help shed a better light on developing an optimal management guideline for the same.
Keywords: Mitral Valve Replacement, Tricuspid Regurgitation, Functional Tricuspid Regurgitation, Tricuspid Ring Annuloplasty