Tricuspid valve repair: is ring annuloplasty superior?
نویسندگان
چکیده
OBJECTIVES Tricuspid regurgitation (TR) secondary to left heart disease is the most common aetiology of tricuspid valve (TV) insufficiency. Valve annuloplasty is the primary treatment for TV insufficiency. Several studies have shown the superiority of annuloplasty with a prosthetic ring over other repair techniques. We reviewed our experience with different surgical techniques for the treatment of acquired TV disease focusing on long-term survival and incidence of reoperation. METHODS A retrospective analysis of 717 consecutive patients who underwent TV surgery between 1975 and 2009 with either a ring annuloplasty [Group R: N = 433 (60%)] or a De Vega suture annuloplasty [Group NR: no ring; N = 255 (36%)]. Twenty-nine (4%) patients underwent other types of TV repair. A ring annuloplasty was performed predominantly in the late study period of 2000-09. TV aetiology was functional in 67% (479/717) of the patients. Ninety-one percent of the patients (n = 649) underwent concomitant coronary artery bypass grafting and/or mitral/aortic valve surgery. RESULTS Patients who received a ring annuloplasty were older (67 ± 13 vs 60 ± 13 years; P < 0.001). Overall 30-day mortality was 13.8% (n = 95) [Group R: n = 55 (12.7%) and Group NR: n = 40 (15.7%)]. Ten-year actuarial survival after TV repair with either the De Vega suture or ring annuloplasty was 39 ± 3 and 46 ± 7%, respectively (P = 0.01). Twenty-eight (4%) patients required a TV reoperation after 5.9 ± 5.1 years. Freedom from TV reoperation 10 years after repair with a De Vega annuloplasty was 87.9 ± 3% compared with 98.4 ± 1% after the ring annuloplasty (P = 0.034). CONCLUSIONS Patients who require TV surgery either as an isolated or a combined procedure constitute a high-risk group. The long-term survival is poor. Tricuspid valve repair with a ring annuloplasty is associated with improved survival and a lower reoperation rate than that with a suture annuloplasty.
منابع مشابه
Is a tricuspid annuloplasty ring significantly better than a De Vega's annuloplasty stitch when repairing severe tricuspid regurgitation?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether tricuspid valve (TV) repair with an annuloplasty ring leads to an improved outcome over a conventional suture annuloplasty for patients with severe tricuspid incompetence. Altogether, 306 papers were found using the reported search, of which 14 presented the best evidence ...
متن کاملOutcomes following use of a modified Duran ring tricuspid valve reconstruction procedure for secondary tricuspid regurgitation.
BACKGROUND Tricuspid valve (TV) repair using ring annuloplasty is reportedly to be superior to suture annuloplasty for treating tricuspid regurgitation (TR). The Duran ring TV annuloplasty technique was modified in order to reduce the risk of complete atrioventricular block and aortic valve injury and the outcomes are reported here. The modification involved not suturing half of the septal annu...
متن کاملValvular Heart Disease Combined Mitral and Tricuspid Valve Repair in Rheumatic Valve Disease Fewer Reoperations With Prosthetic Ring Annuloplasty
Background—We examined predictors of early and very long-term outcome after combined mitral and tricuspid valve repair for rheumatic disease. Methods and Results—Between 1974 and 2002, 153 consecutive patients (mean age, 46.0 13.2 years) underwent combined mitral and tricuspid valve repair for rheumatic disease. Mitral disease was predominantly stenosis (82.3%); 100% of patients had organic tri...
متن کاملTricuspid valve repair with an annuloplasty ring results in improved long-term outcomes.
BACKGROUND The purpose of this study was to compare the long-term results of tricuspid valve (TV) repair with or without an annuloplasty ring. METHODS AND RESULTS 702 patients underwent TV repair at our institution (1978 to 2003), of which 493 had, predominantly, a De Vega procedure (no ring) and 209 had an annuloplasty ring (ring). TV pathology was functional (secondary) in 74% of patients. ...
متن کاملFlexible band versus rigid ring annuloplasty for functional tricuspid regurgitation
We review and compare our experience with tricuspid ring annuloplasty between usage of the Cosgrove-Edwards flexible band and the MC(3) rigid ring for repair of functional tricuspid regurgitation to determine the efficacy and mid-term durability of tricuspid annuloplasty. 117 patients with functional tricuspid regurgitation undergoing open heart surgery and tricuspid valve repair from May 2005 ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
دوره 43 1 شماره
صفحات -
تاریخ انتشار 2013