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Updated: May 22, 2026
08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Concomitant tricuspid valve operations affect outcomes after mitral operations: a multiinstitutional, statewide
Damien J LaPar1, Daniel P Mulloy, Matthew L Stone
1Department of Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
The Annals of Thoracic Surgery
|May 22, 2012
Summary
Performing tricuspid valve procedures during mitral valve operations increases the risk of death and complications. This suggests concomitant tricuspid valve surgery indicates more severe disease and requires careful risk assessment.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Thoracic Surgery
Background:
- Mitral valve (MV) disease frequently co-occurs with tricuspid valve (TV) disease.
- This study investigates the impact of combined MV and TV procedures.
Purpose of the Study:
- To determine the influence of concomitant TV procedures during MV operations on patient outcomes.
- To assess operative death and major complication rates in a multi-institutional setting.
Main Methods:
- Analysis of 5,495 MV operations from 2001-2008 across 17 centers.
- Comparison of 5,062 isolated MV operations with 433 combined MV and TV (MV+TV) operations.
- Univariate and multivariate analyses to assess the impact of TV procedures on mortality and morbidity.
Main Results:
- MV+TV patients were more likely women, had higher rates of heart failure, and more reoperations.
- Combined MV+TV operations had longer bypass times, higher unadjusted mortality (10.4% vs 6.0%), and more complications.
- Risk-adjusted analysis identified concomitant TV procedures as an independent predictor of operative death (OR, 1.50) and major complications (OR, 1.39).
Conclusions:
- Concomitant TV operations signify more advanced valve disease.
- Simultaneous MV+TV operations are linked to increased morbidity and mortality, even after risk adjustment.
- Preoperative risk stratification must consider the elevated risk associated with combined procedures.
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