Réparation chirurgicale de l´insuffisance tricuspide associée à une valvulopathie du cœur gauche: à propos de 162 cas

Tricuspid regurgitation (TR) is a prognostic factor associated with the outcome of patients undergoing surgical treatment of left valvular heart disease. The purpose of this study was to evaluate the postoperative outcome of patients with tricuspid regurgitation associated with left valvular heart disease and to identify factors associated with surgical failure. We conducted a retrospective study of 162 patients over the period January 2009 to July 2019. The study included all patients undergoing surgical treatment of TR and left valve repair. The average age of patients was 39.70 years ± 10.8, with a female predominance. We performed 47 (29%) tricuspid prosthetic annuloplasties, 103 (63.5%) De Vega´s annuloplasties and 12 (7.5%) posterior ring reductions or replacements out of 162 tricuspid valve repairs. Patients´ outcome was marked by clear improvement in morphological and functional echocardiographic parameter means. Surgical failure was reported in 24 (14.8%) patients. Four patients died within 30 postoperative days, reflecting a hospital mortality rate of 2.46%. The causes of death were refractory right ventricular failure (2 cases), and severe left ventricular failure (2 cases). Factors related to failure of tricuspid repair were: severe pre-operative tricuspid failure, postoperative pulmonary hypertension (> 60mmHg) and preoperative RV/LV ratio > 0.6. The results of this study provide a better understanding of the outcomes of patients undergoing surgical treatment of tricuspid failure and provide information on the indications for surgery.