Abstract:

Tricuspid regurgitation (TR) is often underestimated in the assessment and treatment of 
valvular heart disease, despite its well-established prognostic significance. The present study aims 
to evaluate the effect of surgical treatment for functional TR using a multidisciplinary Heart Team 
approach. A total of 72 patients treated at University Hospital “Lozenetz” between 2014 and 2023 
were analyzed. The choice of surgical technique was based on TR etiology, TAPSE, FAC, NYHA 
class, and comorbidities. Valve repair was performed in 91.7% of cases, while valve replacement—
in 8.3%. The mean increase in TAPSE was 2.6 mm, and FAC improved from 30.2% to 33.9%. 
NYHA class improved by ≥1 in 90.3% of patients. Residual TR ≥ II was observed in 11.1%, and in
hospital mortality was 6.9%, higher in patients with TAPSE <12 mm and CKD ≥ III. The findings 
indicate that an individualized Heart Team approach leads to improved outcomes in functional TR. 

Keywords: valve repair, prognostic factors, tricuspid regurgitation, TAPSE, FAC, Heart Team.

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