[Tricuspid incompetence after surgical correction of mitral and mitrio-aortic value diseases. Reasons for its persistence or its recurrence]. / L'insuffisance tricuspidienne après corrections chirurgicales des valvulopathies mitrales et mitro-aortiques. Causes de sa persistance ou de sa récidive

53 patients with mitral or aortic valve disease, observed consecutively, had before operation a marked tricuspid incompetence. 24 had, in the course of corrective mitral or mitral-aortic correction, a surgical attempt at treatment of tricuspid regurgitation; in theremaining 29, tricuspid incompetence was not corrected surgically. The course of the latter group was studied (average follow-up period after operation = 18 months): the operative mortality was 10.3%, and secondary one 20.7%. The functional result was considered good in 55% of the patients, bad (classified III and IV of the NYHA) in 14% of the patients. The postoperative clinical and haemodynamic assessment showed that, in the patients in stages III and IV with persistent ou recurring tricuspid incompetence, the tricuspid lea was, in all cases, secondary to an anomalous function of the left heart (bad function of the prosthesis, persistence of aortic lesions either misvalued or uncorrected). Tricuspid repair in a second stage is unjestified in such cases.