Tricuspid valve leaflet multiplicity and Doppler-derived right-heart hemodynamic trajectories after surgical repair.
6 affiliations
- 1Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.
- 2Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
- 3Department of Pediatric Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
- 4Department of Cardiac Surgery, Heart Center Leipzig at the University of Leipzig, Leipzig, Germany.
- 5Department of Anesthesiology, Sakakibara Heart Institute, Tokyo, Japan.
- 6Sakakibara Heart Institute, Tokyo, Japan.
Abstract
Objective
To determine whether tricuspid leaflet multiplicity is associated with divergent postoperative hemodynamic trajectories after surgical repair.Methods
One hundred seventeen patients undergoing tricuspid valve surgery (January 2023 to March 2025) were prospectively enrolled, with leaflet morphology classified by intraoperative visualization and serial echocardiography over 1 year. The prespecified primary end point was a Doppler-derived tricuspid regurgitation pressure gradient (TRPG) increase, defined as a 5-mm Hg-or-greater increase in TRPG from discharge to 1 year.Results
Among 100 patients with paired data, the primary end point occurred more frequently in the 4/5-leaflet group despite similar residual tricuspid regurgitation (TR) and discharge TRPG (48.5% vs 26.9%; odds ratio, 2.56; 95% CI, 1.07-6.12; P = .034); the age-adjusted association was borderline (aOR, 2.39; P = .054) and the within-group rise significant only in that cohort (P = .024). Severe-or-greater TR recurrence was rare (3.0% vs 0.0%; P = .327). Discharge tricuspid annular plane systolic excursion was lower in the 4/5-leaflet group (0.96 ± 0.36 vs 1.15 ± 0.36 cm; P = .010) but converged by 1 year (P = .585).Conclusions
Tricuspid leaflet multiplicity was associated with a subphenotype showing preserved early TR reduction, lower discharge tricuspid annular plane systolic excursion, and a greater 1-year frequency of Doppler-derived TRPG increase. Morphology-based stratification may refine postoperative surveillance pending external validation.
Related
- Robotic tricuspid valve repair for infective endocarditis with leaflet perforation and severe tricuspid regurgitation
- From maturation to degeneration: Distinct biological trajectories in bicuspid and tricuspid aortopathy
- Percutaneous closure of ruptured sinus of Valsalva and tricuspid paravalvular leak following surgical tricuspid valve replacement.
- Invasive Complications and Infection-Related Reconstruction in Bicuspid Versus Tricuspid Native Aortic Valve Endocarditis: A 12-Year Surgical Cohort Study
- Surgical management of the anterior leaflet in mitral valve repair: the legacy of Professor Alain Carpentier
BibTeX
@article{iwakura2026tricuspid,
title = {{Tricuspid valve leaflet multiplicity and Doppler-derived right-heart hemodynamic trajectories after surgical repair.}},
author = {Tomohiro Iwakura and Mitsunobu Kitamura and Yoshinori Nakahara and Kanako Kishiki and Yuki Izumi and Makoto Ono and Atsushi Yano and Kohei Sumi and Akira Marui and Thilo Noack and Itaru Takamisawa and Mamoru Nanasato and Jun Shimizu and Mitsuaki Isobe},
journal = {JTCVS open},
year = {2026},
month = sep,
doi = {10.1016/j.xjon.2026.102089},
url = {https://europepmc.org/article/MED/42948514},
note = {CC BY},
}
RIS
TY - JOUR
TI - Tricuspid valve leaflet multiplicity and Doppler-derived right-heart hemodynamic trajectories after surgical repair.
AU - Tomohiro Iwakura
AU - Mitsunobu Kitamura
AU - Yoshinori Nakahara
AU - Kanako Kishiki
AU - Yuki Izumi
AU - Makoto Ono
AU - Atsushi Yano
AU - Kohei Sumi
AU - Akira Marui
AU - Thilo Noack
AU - Itaru Takamisawa
AU - Mamoru Nanasato
AU - Jun Shimizu
AU - Mitsuaki Isobe
PY - 2026
DA - 2026/09/01
JO - JTCVS open
DO - 10.1016/j.xjon.2026.102089
UR - https://europepmc.org/article/MED/42948514
AB - Objective To determine whether tricuspid leaflet multiplicity is associated with divergent postoperative hemodynamic trajectories after surgical repair.Methods One hundred seventeen patients undergoing tricuspid valve surgery (January 2023 to March 2025) were prospectively enrolled, with leaflet morphology classified by intraoperative visualization and serial echocardiography over 1 year. The prespecified primary end point was a Doppler-derived tricuspid regurgitation pressure gradient (TRPG) increase, defined as a 5-mm Hg-or-greater increase in TRPG from discharge to 1 year.Results Among 100 patients with paired data, the primary end point occurred more frequently in the 4/5-leaflet group despite similar residual tricuspid regurgitation (TR) and discharge TRPG (48.5% vs 26.9%; odds ratio, 2.56; 95% CI, 1.07-6.12; P = .034); the age-adjusted association was borderline (aOR, 2.39; P = .054) and the within-group rise significant only in that cohort (P = .024). Severe-or-greater TR recurrence was rare (3.0% vs 0.0%; P = .327). Discharge tricuspid annular plane systolic excursion was lower in the 4/5-leaflet group (0.96 ± 0.36 vs 1.15 ± 0.36 cm; P = .010) but converged by 1 year (P = .585).Conclusions Tricuspid leaflet multiplicity was associated with a subphenotype showing preserved early TR reduction, lower discharge tricuspid annular plane systolic excursion, and a greater 1-year frequency of Doppler-derived TRPG increase. Morphology-based stratification may refine postoperative surveillance pending external validation.
SN - 2666-2736
ER -