Related Experiment Video
Updated: Oct 22, 2025
08:42
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
3.7K
Midterm Comparison Between Different Annuloplasty Techniques for Functional Tricuspid Regurgitation
Jens Czapla1, Isabelle Claus1, Thomas Martens1
1Department of Cardiac Surgery, University Hospital of Gent, Ghent, Belgium.
The Annals of Thoracic Surgery
|August 28, 2021
Summary
This study compared three tricuspid annuloplasty (TA) techniques for functional tricuspid regurgitation (TR) repair. Results show that severe right heart conditions, not the TA method, significantly impact midterm survival and TR recurrence.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Interventional Cardiology
Background:
- Functional tricuspid regurgitation (TR) often requires concomitant tricuspid annuloplasty (TA) during other cardiac surgeries.
- Several TA techniques exist, but their comparative midterm outcomes are not well-established.
Purpose of the Study:
- To compare the midterm clinical and valvular outcomes of three distinct tricuspid annuloplasty techniques.
- To identify factors influencing survival and TR recurrence after TA.
Main Methods:
- A total of 307 patients underwent TA using a rigid ring (RA), flexible band (FA), or suture annuloplasty (SA).
- Outcomes assessed included 5-year survival and recurrence of TR greater than grade 2.
- Follow-up was conducted over a median of 3.4 years.
Main Results:
- Five-year survival rates were similar across RA (80.1%), FA (83.5%), and SA (85.1%) groups (P=.471).
- TR recurrence at 5 years was also comparable: 15.9% for RA, 19.4% for FA, and 21.1% for SA (P=.342).
- Independent predictors of mortality included renal impairment, diabetes, and severe right ventricular dysfunction; severe pulmonary hypertension, preoperative TR grade, and residual TR predicted recurrence.
Conclusions:
- The choice of tricuspid annuloplasty technique has minimal impact on midterm survival and TR recurrence.
- Advanced right heart pathologies, specifically severe pulmonary hypertension and right ventricular dysfunction, are the primary determinants of outcomes after functional TR repair.
Related Concept Videos
01:25Mitral Regurgitation III: Medical Management
61
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
61
01:26Mitral Stenosis III: Medical Management
54
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
54
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
91
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
91
01:25Aortic Regurgitation III: Medical Management
84
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
84
01:20Mitral Regurgitation I: Introduction
94
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
94