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The De Vega tricuspid annuloplasty. Perioperative mortality and long term follow-up
R De Paulis1, M Bobbio, G Ottino
1Cattedra di Cardiochirurgia, Università degli Studi di Torino, Turin, Italy.
Insights
The De Vega tricuspid annuloplasty is effective for mild to moderate tricuspid insufficiency. For severe cases, alternative surgical methods may yield better outcomes.
Area of Science:
- Cardiovascular Surgery
- Cardiac Procedures
- Valvular Heart Disease
Background:
- Tricuspid regurgitation is a significant valvular heart disease.
- Surgical repair options for tricuspid insufficiency are crucial for patient outcomes.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of the De Vega tricuspid annuloplasty.
- To identify risk factors for perioperative mortality and reoperation after this procedure.
Main Methods:
- Retrospective analysis of 153 patients undergoing De Vega tricuspid annuloplasty between 1979 and 1987.
- Assessment of operative mortality, long-term survival, reoperation rates, and residual tricuspid regurgitation.
Main Results:
- Operative mortality was 11.1%, with preoperative NYHA class and cardiopulmonary bypass time as significant risk factors.
- Nine-year actuarial survival for operative survivors was 73.5%.
- Reoperation was required in 11 patients, primarily for recurrent tricuspid regurgitation or mitral prosthesis issues.
Conclusions:
- De Vega tricuspid annuloplasty is a suitable surgical option for mild and moderate tricuspid insufficiency.
- For severe tricuspid regurgitation, alternative surgical approaches may be more beneficial.
Abstract:
One hundred and fifty-three patients undergoing De Vega tricuspid annuloplasty, with or without other associated cardiac procedures between January, 1979, and June, 1987, were evaluated. There were 136 hospital survivors. The follow-up was 98.1% complete for a mean of 3.7 years/patient. Operative mortality was 11.1%; preoperative NYHA class and length of CPB were significant risk factors of perioperative mortality. The actuarial survival of operative survivors at 9 years was 73.5 +/- 11.8%. There were 7 late cardiac deaths among a total of 12 late deaths. Eleven patients required reoperation (2.1 +/- 0.6% patient-year). In seven patients it was necessary for recurrence of tricuspid regurgitation; six of these had also a mitral prosthesis malfunction or a periprosthetic leak. Residual tricuspid regurgitation was judged as mild, moderate or severe in 29.9%, 11.9% and 4.3% of the patients respectively. De Vega tricuspid annuloplasty is the method of choice for mild and moderate tricuspid insufficiency; in selected cases, with a more severe degree of regurgitation, better results could be achieved with a different surgical approach.