Value of Concomitant Surgical Correction of Tricuspid Valve Regurgitation in Conventional Aortic and Mitral Valve Surgery

Background: When aortic valve replacement (AVR) or mitral valve repair/replacement (MVRR) is performed, tricuspid regurgitation (TR) is often present. If ignored, TR may worsen and be associated with left-sided valvular heart disease. Because of concerns regarding elevated operation risk, the ideal function of concurrent tricuspid valve repair (TVr) is still up for debate. Objectives: This study aimed to assess the effect of concurrent TVr on the short- and long-term results of patients having AVR or MVRR. Patients and methods: Five hundred patients who had cardiothoracic surgical procedures at Tanta University's Cardiothoracic Surgery Department between 2020 and 2025 were part of this prospective and retrospective comparative analysis. Two groups were formed from the patients: Group A (n=250, AVR/MVRR + TVr) and group B (n=250, AVR/MVRR alone without TVr). Preoperative, intraoperative and postoperative variables were compared. Primary outcomes were all-cause mortality and TR progression. Secondary outcomes included composite morbidity, re-operation and quality of life. Results: Comparing the two studied groups revealed that group A had longer cardiopulmonary bypass time (166.5 ± 28.7 vs. 124.9 ± 25.6 min, p<0.001) and longer cross-clamp time (110.4 ± 23.5 vs. 93.8 ± 18.6 min, p<0.001). Despite this, early outcomes favored group A: Prolonged mechanical ventilation time (8.8% vs. 38.4%), renal failure (4.0% vs. 27.2%) and major morbidity (14% vs. 46.4%) were significantly lower (p<0.001). Mortality (5.6% vs. 11.2%, p=0.024) and stroke (1.2% vs. 5.2%, p=0.011) were also reduced. ICU stay was shorter in group A (46.4 ± 14.7 vs. 83.1 ± 28.1 hrs, p<0.001). Conclusion: Concomitant TVr during AVR or MVRR improved perioperative and long-term outcomes without increasing operative risk, supporting early intervention in moderate-to-severe TR.