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You are here: Contents > 2017 > Volume 26 Number 3 May 2017 > MITRAL VALVE DISEASE > Progression of Tricuspid Regurgitation after Mitral Valve Replacement for Rheumatic Heart Disease

Progression of Tricuspid Regurgitation after Mitral Valve Replacement for Rheumatic Heart Disease

Ho H. Q. Tri1,4, Pham N. Vinh2,3

1Heart Institute, Ho Chi Minh City, Vietnam
2Pham Ngoc Thach Medical University, Ho Chi Minh City, Vietnam
3Tam Duc Heart Hospital, Ho Chi Minh City, Vietnam
4Electronic correspondence: hohuynhquangtri@yahoo.com

Background and aim of the study: Progression of tricuspid regurgitation (TR) may occur after mitral valve replacement (MVR). The study aim was to define the independent predictors for new severe TR after MVR to treat rheumatic heart disease.

Methods: A total of 413 patients (177 men, 236 women; mean age 40.9 ± 9.2 years) with rheumatic heart disease undergoing MVR without concomitant tricuspid valve repair at the authors’ institute between 1995 and 2005, who did not have preoperative severe TR, were followed for at least one year postoperatively. Survival without severe TR was estimated using the Kaplan-Meier method. Independent predictors for new severe TR were identified using multiple Cox regression analysis.

Results: During a median follow up of 13 years there were


two late deaths, and 46 patients (11.1%) had new severe TR. Survival without severe TR was 88.0 ± 1.7% at 10 years. Independent predictors for new severe TR were preoperative moderate TR (HR 2.401; p = 0.008) and atrial fibrillation (AF) (HR 2.119; p = 0.018). At the most recent follow up, furosemide was used in 23.9% patients with and 7.3% patients without new severe TR (p = 0.001). Patients with new severe TR had larger right ventricles and higher pulmonary artery pressures on echocardiography.

Conclusion: Among patients with rheumatic heart disease undergoing MVR without concomitant tricuspid valve repair, independent predictors for new severe TR were preoperative moderate TR and AF. New severe TR was associated with increased furosemide use.

The Journal of Heart Valve Disease 2017;26:290-294


Progression of Tricuspid Regurgitation after Mitral Valve Replacement for Rheumatic Heart Disease

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