5th International Conference on Heart and Cardiovascular Diseases

Yonas Teferi is a Consultant Cardiothoracic Surgeon and Chief of Cardiothoracic Surgery at the AGC Tenwek Cardiothoracic Centre in Bomet County, Kenya. He is a Fellow of the College of Surgeons of Eastern, Central, and Southern Africa (FCS[ECSA]). Dr. Teferi earned his medical degree and completed his general surgical training at Addis Ababa University in Ethiopia. He subsequently pursued fellowship training in cardiothoracic surgery through the Pan-African Academy of Christian Surgeons (PAACS) at Tenwek Hospital, Kenya. His clinical practice encompasses adult and pediatric cardiac surgery, thoracic and vascular surgery, and perioperative critical care, with a particular focus on livering high-quality care in resource-limited settings. He is deeply committed to surgical education, mentorship, and capacity building across the region. In addition to his clinical and educational roles, Dr. Teferi has authored numerous publications in peer-reviewed journals and is actively involved in the development of regional cardiothoracic surgery data registries aimed at improving outcomes, research, and quality improvement initiatives throughout sub-Saharan Africa.

Background

Functional tricuspid regurgitation (TR) frequently complicates rheumatic left-sided valve disease, yet evidence regarding concomitant tricuspid valve repair (TVR) in rheumatic populations from low-resource settings remains limited. We evaluated early and short-term outcomes following concomitant TVR.

Methods

We retrospectively reviewed patients undergoing concomitant TVR during rheumatic left-sided valve surgery at Tenwek Hospital (2022–2025). TVR was performed for severe TR or mild-to-moderate TR with annular dilation and/or right heart failure. Outcomes included ≥ moderate TR, mortality, functional and RV status, pacemaker implantation, and reintervention.

Results

Among 123 patients (mean age, 30.7 ± 16.1 years; 59.3% female), 89.4% had ≥ moderate TR and 66.7% had severe TR preoperatively. Ring annuloplasty was performed in 97.6%. Operative mortality was 4.1%. At a median follow-up of 11.5 months, ≥ moderate TR was present in 17 of 118 patients (14.4%); 4 (3.4%) had persistent/residual TR and 13 of 105 (12.4%) developed recurrent/progressive TR after initially having less than moderate TR. Kaplan-Meier analysis demonstrated 85.6% freedom from ≥ moderate TR. New York Heart Association functional class improved significantly, with 97.4% of patients in class I-II at follow-up. Right ventricular function declined early postoperatively but partially recovered.

Conclusions

Concomitant TVR was associated with low operative mortality, improved functional status, and acceptable short-term durability despite advanced disease. These findings support its feasibility in appropriately selected rheumatic patients, including in resource-limited settings.