title: Prevalence of Late Functional Tricuspid Regurgitation in Degenerative Mitral Regurgitation Surgery.
abstract: Although significant late tricuspid regurgitation (TR) may develop after surgery for degenerative mitral regurgitation (MR), the use of routine tricuspid annuloplasty is debatable. The study aim was to determine the prevalence and predictors of significant late TR after surgery for degenerative MR.
  
  
  
  A total of 112 patients who had undergone surgery for degenerative MR without concomitant tricuspid valve repair (average follow up 7.7 ± 4.0 years) was studied retrospectively. The prevalence of post-surgical TR and predictors of progression were determined.
  
  
  
  The majority of patients (97%) had non-significant TR (less than moderate) prior to surgery, although an overall trend of progression towards significant TR (grades 2 or 3) was noted in 17 patients (p = 0.0006). Of the 18 patients (16%) with late postoperative significant TR, only nine (8%) had severe TR with only a single referral to surgery. New-onset post-surgical atrial fibrillation was more common in patients who developed late significant TR (p = 0.002). Multivariate analysis of the pre-surgery variables, age >65 years and left ventricular dysfunction were shown to be independent predictors of late functional TR.
  
  
  
  Significant progression in TR after surgery for degenerative MR was rare in this patient cohort. The impact of older age and left ventricular dysfunction at the time of surgery showed a strong association with post-surgical atrial fibrillation.
authors.affiliation: Rabin Medical Center, Beilinson Hospital, Petach-Tikva.
authors.forename: Mordehay
authors.initials: M
authors.lastname: Vaturi
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Kotler
authors.affiliation: Rabin Medical Center, Beilinson Hospital, Petach-Tikva.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Shapira
authors.affiliation: Rabin Medical Center, Beilinson Hospital, Petach-Tikva.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisenberg
authors.affiliation: Rabin Medical Center, Beilinson Hospital, Petach-Tikva.
authors.forename: Daniel
authors.initials: D
authors.lastname: Monakier
authors.affiliation: Rabin Medical Center, Beilinson Hospital, Petach-Tikva.
authors.forename: Alexander
authors.initials: A
authors.lastname: Sagie
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D015999:Multivariate Analysis; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000503:physiopathology*; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology