Siddarth Ramkumar
Research Mentor(s): Steven Bolling
Mentor Department: The Department of Cardiac Surgery
Authors: Catherine M Wagner, Whitney Fu, Alexander A Brescia, Jessica Woodford, China Green , Donald S Likosky, Robert B Hawkins, Matthew A Romano , Gorav Ailawadi, Steven F Bolling , Siddarth Ramkumar
Session: Session 6 (3:00pm – 3:50pm)
Presentation Type: Poster 22
Abstract
The mitral valve regulates blood flow between the left atrium and left ventricle of the heart ensuring unidirectional circulation. Diseases affecting this valve can result in increased left atrial pressure and right ventricle overload, contributing to the development of tricuspid regurgitation, where the tricuspid valve fails to properly close during systole. This can result in backflow of blood to the right atrium and lead to long term heart failure and other complications. A common solution is mitral valve surgery/repair which is often paired with tricuspid surgeries since these complications come in tandem. Tricuspid surgeries are often proposed for patients with moderate to worse tricuspid regurgitation(TR) to prevent further progression of TR and reduce reoperation risk. This study seeks to prove that women are less likely to have successful TR reduction because they are less likely to receive concomitant tricuspid valve repair(tvr) after mitral surgery, likely due to failed metrics in guideline-recommendations. This was proved from compiling data from patients with at least moderate grade preoperative TR from 2014 to 2023 and using a risk model to compare development of severe tricuspid regurgitation for those who had tvr to those who didn’t. The unadjusted results indicated that only 57 percent of women received tvr compared to 73 percent of men with a significant p value of less than 0.001, and 12% of women who did not undergo tvr developed severe TR. This indicates tricuspid repairs are significantly less common in women, increasing their levels of tricuspid regurgitation and putting them at higher levels of health risks and disease progression. It is evident there are sex based differences in current models of assessing care when treating women with mitral valve disease and it represents a critical issue in the health system requiring immediate attention and further large scale studies.
