Post-Heart Transplant Tricuspid Regurgitation: Prevalence and Risk Factor Analysis

Purpose Tricuspid valve regurgitation (TVR) is a relatively common sequela immediately after cardiac transplantation. The occurrence of TVR has been known to reduce after the adoption of the bicaval anastomosis technique. However, the fate of the TV disease after this technique has not been clearly quantified. Methods Consecutive 509 adult patients (49.1 ± 12.7 years; 157 females) who underwent orthotopic heart transplantation with bicaval technique at our institution from January 2001 to December 2018 were enrolled. During the 73.98 months of median follow up period (IQR 39.53-118.13), changes of TVR on transthoracic echocardiography at 1 month, 1 year, 3 year, 5 year was investigated. Results The severities of TVR immediate after HT were less than mild (n=194, 40.8%), mild (n=253, 53.3%), moderate (n=20, 4.2 %) and severe (n=8, 1.7%). The rate of significant TR during the follow-up was 22/475 (4.63%, OR 0.78, 95% CI 0.53-1.15), 9/459 (1.96%, OR 0.33, 95% CI 0.16-0.67), 6/387 (1.55%, OR 0.28, 95% CI 0.13-0.60), and 4/289 (1.38%, OR 0.30, 95% CI 0.14-0.64) in 1 month, 1year, 3 year, and 5 year, respectively. Generalized estimating equations demonstrated that the proportion of TVR decreased overtime after surgery ( overall P Conclusion In the patients undergoing heart transplantation with bicaval technique, the incidence of significant TR is common immediately after surgery. However, it shows a trend of improvement over time.