October 2025, Volume 3, Issue 10

Author

Anand Ajaykumar, Rajesh Sadanandan, Sajiv Kunnuthukathil Paul, Kudakkachira Mathew Kuriakose and Najeeb Palakuzhiyil

Abstract

Introduction: Tricuspid regurgitation (TR) frequently coexists with left-sided valvular disease and may progress despite surgical correction of the primary lesion. Although once considered clinically insignificant, evidence increasingly supports early recognition and intervention. This study was undertaken to evaluate the progression of TR in Participants undergoing cardiac surgery for other primary lesions and to identify factors influencing its progression. Materials and Methods: A prospective observational study was conducted on 50 Participants with preoperative TR who underwent cardiac surgery for left-sided valvular or structural heart disease. Ethical clearance and informed consent were obtained. Participants underwent comprehensive preoperative and serial postoperative echocardiographic evaluation, including tricuspid annulus diameter, tricuspid annular plane systolic excursion (TAPSE), right ventricular (RV) dimensions, and ejection fraction (EF). Follow-up assessments were performed at six months and one year. Data were analysed using SPSS, with significance set at p<0.05. Results: The mean age was 45.8 ± 9.3 years, with 62% male predominance. Severe mitral stenosis was the most common primary lesion (56%). At baseline, mean tricuspid annulus was 30.2 mm and TAPSE 17.3 mm, with no RV dilatation. By one year, the mean annulus had increased to 36.1 mm (p<0.001), TAPSE declined to 15.0 mm (p<0.001), and RV dilatation was observed in 38% of Participants. Nineteen Participants (38%) developed severe TR, most commonly in mitral stenosis and CAD+MR subgroups. Advancing age was significantly associated with persistence of regional wall motion abnormalities (p=0.020), while gender showed no influence. Conclusion: TR progression after cardiac surgery is frequent, strongly influenced by disease type and age, and identifiable through simple echocardiographic parameters. Systematic postoperative surveillance and timely intervention are essential to prevent severe symptomatic TR and preserve right ventricular function.