I met many patients who had undergone mitral valve replacement for rheumatic mitral valve diseased and the surgeons had missed the organic tricuspid valve disease and leave it without repair and the net result after some time is a patient with well-functioning mitral valve prosthesis and organic tricuspid valve disease with severe tricuspid stenosis and/or regurgitation with marked systemic congestion, ascitis, and sometimes even cardiac liver cirrhosis. The question is about the cardiac surgery for just repair of tricuspid valve in such cases, is it feasible ?
In severe tricuspid valve disease after MV Replacement, We should intervene. One problem is which approach; surgical versus medical(loop diuretics, Spironolactone and or dialysis) versus percutaneously. 2 nd problem is the timing of intervention. 3rd problem is that REDO intervention with its harzards. 4th is the presence of pacemaker wires.
Tricuspid regurgitation after successful mitral valve surgery. Katsi V et al. Interact Cardiovasc Thorac Surg. (2012)
It is feasible, but high incidence of postoperative RV failure and associated mortality.
I have operated on many pts. with organic tv disease and organic mv disease. the third author is right. postop rv dysfunction and associated mortality is higher but it is worth it in selected cases. probal ghosh.
I agree with the fact that it is possible to surgically intervene if medical treatment is not controlling the situation. To me the must important point is that patients should be properly diagnosed and thoroughly evaluated prior to the initial surgery and surgeons should have the knowledge, criterion, training and expertise, to perform the correct and complete surgical procedure during the initial operation.
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