Concomitant Tricuspid Valve Repair During Mitral Valve Surgery: Indication and Surgical Outcome

Background: Tricuspid valve repair has been recently advocated in patients undergoing mitral valve surgery who have mild to moderate secondary tricuspid regurgitation. The study aimed to find out how the concomitant performance of tricuspid valve repair (TVR) affects outcomes of patients undergoing mitral valve surgery (MVS). Methodology: Retrospective cross sectional analytical study that was carried out from 15 June to 31 December 2020 in Ibn Al-Bitar hospital for cardiac surgery and Iraqi heart center of 24 patients that were referred for MVR. and TV. repair from 6 up to 3 years were they assessed preoperatively, intraoperative and postoperative. Data collected from patient's files in data were retrieved from the hospital data collecting .The follow up after phoning patient and contact with them by what's up application for sending their data and echocardiogram reports. Results: The total sample was 24 patients. The mean age was 59.7+/- 6.4 year ,Female forming 58.3% and male was 43.7%.The new York Heart Association (NYHA) on collected patients showed class ΙΙΙ in 75% patients and class Ιν in 25% in preoperative period improved reversely to became 75% in class Ι and 25% in class ΙΙ after 6 months while after 1 year the patients reclassified to [25%, 20.8%,4/1% and 50% with class Ι,ΙΙ,ΙΙΙ, and asymptomatic respectively ] and in to [45.8%, 16.6%, and 37.5% with class Ι,ΙΙ and asymptomatic respectively after 3 years]. Preoperative echocardiographic assessment showed that the mean of annular size was 31.5+/-2.9 mm.( ranging 27mm-38mm).The average length of stay in the intensive care unit (ICU) 2.7+/- 2.1 days, 2(8.3%) patient need for pacemaker, acute renal failure developed in 1 patient and there were no bleeding, madiastinitis, wound infection, thromboembolisation, endocarditis and death. The study showed the postoperative progression of the TR. was 8(33.3%) with moderate TR. and 16(66.7%) with sever TR. improved in 6 months in to [6(25%), 12(50%),and 6(25%) with no TR. ,mild TR. and moderate TR. respectively ] and in to [14(58.3%),8(33.3%),2(8.3%) with no TR, mild and moderate TR. respectively] after 1 year and [4(16.6%),16(66.7%) with no TR. and mild TR. and 2 (8.3%) with moderate and sever TR.]after 3 years. Conclusion: All patients with moderate – sever tricuspid are candidate for repair. The short term outcome show improvement in functional state and in valve regurge but in mid – long term outcome there is gradual decrease in it.