FU.T.U.RE. STUDY (FUNCTIONAL TRICUSPID UPDATE STUDY ON RECURRENCE)

Background and Aim: In current clinical practice, tricuspid valve surgery is often overlooked and lacks adequate standardization. This leads to a considerable risk of tricuspid regurgitation recurrence after mitral-tricuspid surgery, significantly affecting patient outcomes. Our study investigates the predictive role of demographic, clinical, echocardiographic, and surgical factors in tricuspid regurgitation recurrence to help address this critical prognostic challenge. Methods: This single-center, ambispective, observational study included 178 patients who underwent mitral-tricuspid surgery at our institution between January 2012 and June 2019. Follow-up data were collected at an average of 6 years post-intervention. We conducted a univariable analysis of major demographic, clinical, echocardiographic, and surgical factors. Significant and suggestive predictors were integrated into a multivariable model, from which we developed a nomogram as a predictive tool. Results: Univariable analysis revealed several parameters significantly associated with an increased risk of recurrent tricuspid regurgitation. Following multivariable analysis, suture ring-less repair emerged as an independent predictor of recurrence, linked with a 3.7-fold increased recurrence risk. All factors included in the multivariable model were subsequently incorporated into a scoring system designed to predict 5-year recurrence-free survival before surgery. Conclusions: Our innovative scoring system’s aim is to contribute to building in the “real world” a uniform and patient-tailored perspective for functional tricuspid valve regurgitation surgery. This knowledge could help improving patient care as well as contributing to the advancement of surgical strategies in this critical area of surgery.