Heemoon Lee1, Dong Seop Jeong1, Wook Sung Kim1, Kiick Sung1, Keumhee Chough Carriere2, Sung-Ji Park3, Pyo Won Park4. 1. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada; Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 4. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: pwpark@skku.edu.
Abstract
BACKGROUND: This study aimed to evaluate the long-term clinical impacts of prophylactic tricuspid annuloplasty (TAP) in patients with mild tricuspid regurgitation (TR) who underwent mitral valve repair. METHODS: One hundred fifty-one patients with mild TR who underwent mitral valve repair for degenerative mitral regurgitation between 1997 and 2013 were categorized into the TAP (n = 85) or no TAP (n = 66) groups. The indications for TAP were atrial fibrillation and tricuspid annular dilatation. The mean follow-up duration was 115.5 ± 48.6 months. Inverse probability of treatment weighting analysis and propensity score matching with 53 patients in each group were used to adjust for the baseline differences between the 2 groups. RESULTS: There were no early mortalities in either group, and early morbidities, including heart block, were not different between the groups. Inverse probability of treatment weighting-adjusted survival analysis did not reveal any difference in overall survival (P = .862), freedom from cardiac-related mortality (P = .535), or major adverse valve-related events (P = .972) between the groups. There was no difference in late TR progression (moderate or greater) between the groups (P = .316). These results were consistent in the matched analysis. CONCLUSIONS: Prophylactic TAP in mild TR may not have a beneficial effect on TR progress in degenerative mitral regurgitation. Further large studies are necessary to define the role of prophylactic TAP in mild TR.
BACKGROUND: This study aimed to evaluate the long-term clinical impacts of prophylactic tricuspid annuloplasty (TAP) in patients with mild tricuspid regurgitation (TR) who underwent mitral valve repair. METHODS: One hundred fifty-one patients with mild TR who underwent mitral valve repair for degenerative mitral regurgitation between 1997 and 2013 were categorized into the TAP (n = 85) or no TAP (n = 66) groups. The indications for TAP were atrial fibrillation and tricuspid annular dilatation. The mean follow-up duration was 115.5 ± 48.6 months. Inverse probability of treatment weighting analysis and propensity score matching with 53 patients in each group were used to adjust for the baseline differences between the 2 groups. RESULTS: There were no early mortalities in either group, and early morbidities, including heart block, were not different between the groups. Inverse probability of treatment weighting-adjusted survival analysis did not reveal any difference in overall survival (P = .862), freedom from cardiac-related mortality (P = .535), or major adverse valve-related events (P = .972) between the groups. There was no difference in late TR progression (moderate or greater) between the groups (P = .316). These results were consistent in the matched analysis. CONCLUSIONS: Prophylactic TAP in mild TR may not have a beneficial effect on TR progress in degenerative mitral regurgitation. Further large studies are necessary to define the role of prophylactic TAP in mild TR.