JUAN A. CRESTANELLO: Welcome to the Cardiovascular Surgery Series, where I review the latest research in cardiovascular surgery from the Mayo Clinic. I will review, today, the impact of tricuspid valve regurgitation on intermediate outcomes of degenerative mitral valve surgery. I am Dr. Juan Crestanello.

In this study, we examine the progression of tricuspid regurgitation, patient survival, and reoperations in patients who had undergone mitral valve surgery for degenerative mitral valve disease. We operated in approximately 1,600 patients who had mitral valve surgery for degenerative mitral regurgitation.

Tricuspid regurgitation was moderate or severe in a third of those patients. And only 15% of those patients had concomitant tricuspid valve surgery. The likelihood of tricuspid valve surgery increased with the severity of the tricuspid regurgitation.

TR grades improve more in patients with concomitant tricuspid valve intervention, regardless of the severity of the preoperative triscupid regurgitation. And these trends are maintained during the long-term follow up. The risk of progression to severe triscupid regurgitation was not influenced by tricuspid annulus diameter, either when that was analyzed as a continuous variable or as a categorical variable with diameters less or greater than four centimeters.

Long-term survival following mitral valve surgery was similar in patients with or without tricuspid valve intervention. The rate of reoperation was observed in only 1.5% of the patients.

We conclude that concomitant tricuspid valve surgery for moderate TR reduces progression of tricuspid regurgitation, but did not influence survival or incidence of reoperation. Among patients with less than severe preoperative TR, tricuspid annular diameter was not associated with progression to severe tricuspid regurgitation. Thank you for listening to the Mayo Clinic Cardiovascular Surgery Series.