Hemodynamic studies after De Vega's tricuspid annuloplasty

Postoperative hemodynamic studies were conducted at rest and during exercise in 24 patients who, in addition to mitral and/or aortic valve surgery, had De Vega's tricuspid annuloplasty. To determine the degree of tricuspid insufficiency (TI), right atrial pressure (PRA) tracings, biplane right ventricular cineangiograms, and ultrasonic Doppler flow patterns were obtained. The TI improved in 14 patients, but still remained mild to moderate in 20 patients. In addition, a mild-to-moderate tricuspid stenosis with pressure gradients from 2 to 7.8 mm Hg were found in 12 patients. There was no significant change in the mean PRA, with 8.0 +/- 4.5 mm Hg preoperatively and 7.5 +/- 3.5 mm Hg postoperatively at rest. During exercise, PRA rose to 17.0 +/- 6.5 mm Hg. The unsatisfactory results are also due to the persistent elevation of left atrial and pulmonary artery pressure after left heart surgery. De Vega's annuloplasty does not answer the tricuspid challenge, since the results are unpredictable.