Progression of Tricuspid Regurgitation in Participants Undergoing Surgeries for Other Cardiac Diseases and Factors Influencing

Introduction: Tricuspid regurgitation (TR) frequently coexists with left-sided valvular disease and may progress despite surgical correction of the primary lesion. Although once considered clinically insignificant, evidence increasingly supports early recognition and intervention. This study was undertaken to evaluate the progression of TR in Participants undergoing cardiac surgery for other primary lesions and to identify factors influencing its progression. Materials and Methods: A prospective observational study was conducted on 50 Participants with preoperative TR who underwent cardiac surgery for left-sided valvular or structural heart disease. Ethical clearance and informed consent were obtained. Participants underwent comprehensive preoperative and serial postoperative echocardiographic evaluation, including tricuspid annulus diameter, tricuspid annular plane systolic excursion (TAPSE), right ventricular (RV) dimensions, and ejection fraction (EF). Follow-up assessments were performed at six months and one year. Data were analysed using SPSS, with significance set at p<0.05. Results: The mean age was 45.8 ± 9.3 years, with 62% male predominance. Severe mitral stenosis was the most common primary lesion (56%). At baseline, mean tricuspid annulus was 30.2 mm and TAPSE 17.3 mm, with no RV dilatation. By one year, the mean annulus had increased to 36.1 mm (p<0.001), TAPSE declined to 15.0 mm (p<0.001), and RV dilatation was observed in 38% of Participants. Nineteen Participants (38%) developed severe TR, most commonly in mitral stenosis and CAD+MR subgroups. Advancing age was significantly associated with persistence of regional wall motion abnormalities (p=0.020), while gender showed no influence. Conclusion: TR progression after cardiac surgery is frequent, strongly influenced by disease type and age, and identifiable through simple echocardiographic parameters. Systematic postoperative surveillance and timely intervention are essential to prevent severe symptomatic TR and preserve right ventricular function.

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Publication Details

Journal
NATIONAL BOARD OF EXAMINATIONS JOURNAL OF MEDICAL SCIENCES
Published
2025-10-03
DOI
https://doi.org/10.61770/nbejms.2025.v03.i10.007
Primary Topic
Cardiac Valve Diseases and Treatments
Type
article
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article

Progression of Tricuspid Regurgitation in Participants Undergoing Surgeries for Other Cardiac Diseases and Factors Influencing

Swapan Paul, Anthyalam Parambil Ajaykumar, Kudakkachira Mathew Kuriakose, Rajesh Sadanandan et al.
NATIONAL BOARD OF EXAMINATIONS JOURNAL OF MEDICAL SCIENCES
Cardiac Valve Diseases and Treatments
article

Progression of Tricuspid Regurgitation in Participants Undergoing Surgeries for Other Cardiac Diseases and Factors Influencing

Swapan Paul, Anthyalam Parambil Ajaykumar, Kudakkachira Mathew Kuriakose, Rajesh Sadanandan, Najeeb Palakuzhiyil
article en

Abstract

Introduction: Tricuspid regurgitation (TR) frequently coexists with left-sided valvular disease and may progress despite surgical correction of the primary lesion. Although once considered clinically insignificant, evidence increasingly supports early recognition and intervention. This study was undertaken to evaluate the progression of TR in Participants undergoing cardiac surgery for other primary lesions and to identify factors influencing its progression. Materials and Methods: A prospective observational study was conducted on 50 Participants with preoperative TR who underwent cardiac surgery for left-sided valvular or structural heart disease. Ethical clearance and informed consent were obtained. Participants underwent comprehensive preoperative and serial postoperative echocardiographic evaluation, including tricuspid annulus diameter, tricuspid annular plane systolic excursion (TAPSE), right ventricular (RV) dimensions, and ejection fraction (EF). Follow-up assessments were performed at six months and one year. Data were analysed using SPSS, with significance set at p<0.05. Results: The mean age was 45.8 ± 9.3 years, with 62% male predominance. Severe mitral stenosis was the most common primary lesion (56%). At baseline, mean tricuspid annulus was 30.2 mm and TAPSE 17.3 mm, with no RV dilatation. By one year, the mean annulus had increased to 36.1 mm (p<0.001), TAPSE declined to 15.0 mm (p<0.001), and RV dilatation was observed in 38% of Participants. Nineteen Participants (38%) developed severe TR, most commonly in mitral stenosis and CAD+MR subgroups. Advancing age was significantly associated with persistence of regional wall motion abnormalities (p=0.020), while gender showed no influence. Conclusion: TR progression after cardiac surgery is frequent, strongly influenced by disease type and age, and identifiable through simple echocardiographic parameters. Systematic postoperative surveillance and timely intervention are essential to prevent severe symptomatic TR and preserve right ventricular function.

NATIONAL BOARD OF EXAMINATIONS JOURNAL OF MEDICAL SCIENCESVol. 3(10)
Openalex Percentile: Top 58%
Cardiac Valve Diseases and Treatments
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