[Mechanisms of tricuspid insufficiency in the follow-up of patients post orthotopic heart transplantation].

Introduction: Tricuspid regurgitation (TR) is the most frequent valvulopathy after cardiac transplantation, with an incidence ranging from 19% to 84%. Severity increases with follow-up. The objectives were to describe the mechanisms involved in the development of post-transplantation TR.

Materials and methods: Single-center, retrospective cohort study including patients who received orthotopic heart transplantation between 2012 and 2022. Echocardiograms were performed at 6, 12 and 18 months' post-transplantation. The mechanisms of tricuspid regurgitation described were atrial dilatation or bi-atrial technique, multiple endomyocardial biopsies, right ventricular dilatation and dysfunction, previous pulmonary hypertension and mismatch of the recipient cavity with the transplanted organ.

Results: A total of 234 patients were included. The incidence of significant tricuspid regurgitation from 6 months post-transplantation was 12.8%. Right ventricular dilatation and dysfunction was the most prevalent mechanism in 67%, mismatch 17%, organic valve lesion and previous pulmonary hypertension 7% and atrial dilatation 3%. The 40% of patients who had right ventricular dysfunction also presented left ventricular dysfunction.

Discussion: The incidence of tricuspid regurgitation in heart transplant patients was 12.8% during the follow-up. The main mechanism observed was the right ventricular dilatation and dysfunction.