[Tricuspid annuloplasty and right ventricular function in mitral valve disease]

Area of Science:

• Cardiovascular Surgery
• Cardiac Physiology
• Valvular Heart Disease

Context:

• Mitral valve disease often coexists with tricuspid valve pathology.
• Tricuspid regurgitation (TR) can significantly affect right ventricular (RV) function.
• Understanding the impact of TR on RV function is crucial for surgical outcomes.

Purpose:

• To investigate the relationship between tricuspid valve lesions and right ventricular function in patients with mitral valve disease.
• To evaluate the impact of tricuspid annuloplasty (TAP) on RV function in patients with and without TR.
• To assess the correlation between pulmonary vascular resistance and RV function postoperatively.

Summary:

• This study analyzed 31 patients with mitral valve disease, comparing 17 with TR (Group I) and 14 without TR (Group II) undergoing TAP.
• Both groups showed improvements in pulmonary hemodynamics and cardiac index postoperatively.
• Group I (with TR) demonstrated significant postoperative improvement in RV end-diastolic and end-systolic volumes, while Group II maintained normal RV volumes.
• Preoperative pulmonary artery resistance (PAR) inversely correlated with postoperative RV ejection fraction (RVEF), indicating poorer RV function with severe pulmonary vascular lesions.
• Right ventricular end-systolic volume index (RVESVI) was inversely correlated with RVEF both pre- and postoperatively, highlighting its influence on RV pump function.

Impact:

• Tricuspid annuloplasty effectively improves RV function in patients with mitral valve disease and coexisting tricuspid regurgitation.
• Pulmonary vascular resistance is a key factor influencing postoperative RV function.
• RVESVI is a significant determinant of RV pump performance in this patient population.