BACKGROUND AND AIM OF THE STUDY: Residual or recurrent tricuspid regurgitation (TR) has been reported after several types of surgical tricuspid repair. The development of late TR is an important complication of left heart surgery. The results of De Vega annuloplasty were compared with those obtained after Carpentier-Edwards ring (CE ring) annuloplasty in patients with secondary TR.
METHODS: The study was carried out on 126 patients who underwent surgery for secondary TR between January 1998 and November 2007. Eighty patients underwent De Vega annuloplasty (group I), and 46 had a CE ring annuloplasty (group II). The groups were similar with respect to associated cardiac lesions. No significant preoperative differences were observed in NYHA functional class, TR grade, and pulmonary artery pressure between the two groups.
RESULTS: All patients were followed-up for an average of 43±17 (range, 1 to 96) months. There were eight in-hospital and eighteen late deaths. Including operative deaths, actuarial overall survival in group I at 5 years was 78.8% versus 80.5%, in group II (P =0.7654),and tricuspid valve related mortality was (14.6%) in group I versus 0% in group II (P=0.000072). Postoperative NYHA class I or II symptoms were present in 88.8% of group I versus 97.2% of group II (P=0.134). Echocardiographic studies showed that TR was well controlled within grade 2+ in nearly 70% of group I versus 92% of group II (P=0.01). The improvement of TR was not adversely affected by commonly recognized risk factors for tricuspid repair failure in group2 patients versus those in group I. The tricuspid valve reoperation-free survival rate at 5 years was 93.7% (4/63) in group I versus 0% in group II (P=0.01).
Conclusions: Placement of an annuloplasty ring during tricuspid valve repair is associated with a decreased recurrence of TR, and with improved long-term survival and event-free survival. An annuloplasty ring should therefore be used more routinely in tricuspid valve surgery.
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