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Adjustable segmental tricuspid annuloplasty: technical advantages and midterm results
Anas Sarraj1, José-Manuel Nuche, Lourdes Domínguez
1Department of Cardiovascular Surgery, Hospital Universitario de La Princesa, Universidad Autónoma, Madrid, Spain. anas_sarraj@hotmail.com
The Annals of Thoracic Surgery
|March 28, 2009
Summary
Adjustable segmental tricuspid annuloplasty effectively treats functional tricuspid regurgitation (TR), showing improved clinical outcomes and reduced TR severity. The procedure demonstrates technical advantages for patients with TR.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Echocardiography
Background:
- Functional tricuspid regurgitation (TR) poses a significant clinical challenge.
- Adjustable segmental tricuspid annuloplasty is an emerging surgical technique.
Purpose of the Study:
- To present the technical advantages of adjustable segmental tricuspid annuloplasty.
- To analyze the early and midterm clinical and echocardiographic results of this procedure.
Main Methods:
- Prospective study of 17 patients with moderate/severe functional TR undergoing adjustable segmental tricuspid annuloplasty.
- Preoperative and serial postoperative transthoracic echocardiography (TTE) at discharge, 3-6 months, and mean 30.4 months follow-up.
- Assessment of tricuspid valve, right ventricle, and left ventricle parameters.
Main Results:
- No hospital mortality; progressive clinical improvement observed.
- Significant reduction in TR severity (13/17 patients with mild or less TR).
- Tricuspid annulus diameter normalized, pulmonary hypertension regressed, and right ventricular/inferior vena cava diameters decreased.
Conclusions:
- Adjustable segmental tricuspid annuloplasty is an effective and improved procedure for functional TR.
- The technique offers selectivity, adjustability, and resistance.
- Poor left ventricular function and pacemaker leads may negatively impact outcomes.