[Isolated surgery of tricuspid insufficiency in valvular reoperation]

Development of late tricuspid regurgitation (TR) following prior operation on left heart valves is associated with an important impairement of functional status and adverse prognosis. Indications and outcomes of surgery in this setting are not well defined. Our Department experience in isolated TR in valve reoperation is evaluated.

Twenty-four patients underwent isolated tricuspid valve surgery because of severe TR following a prior operation on left heart valves between January/1990 and July/2003. Patients with congenital heart disease, traumatic TR, infectious endocarditis or left heart valve disfunction were excluded. The retrospective and observational study of this group of patients included clinical echocardiographic, haemodynamic and surgical data evaluation.

Mean follow-up time was 4.4+/-3.5 years and included all patients. There was no operative mortality but actuarial survival at six years was 48%. No risk factors for late death were identified.

Isolated tricuspid surgery for severe TR in patients with previous left heart valve surgery can be done with acceptable hospital mortality. Low operative mortality does not mean medium term good results. High late mortality and unsatisfactory functional results should lead us to consider other options when treating tricuspid valve regurgitation.