Tricuspidal annuloplasty. Results and complications

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Adult Congenital Heart Disease

Background:

• Tricuspid regurgitation (TR) is a significant valvular heart disease, often functional and secondary to other cardiac conditions.
• Surgical intervention, such as tricuspid annuloplasty (TA), is considered for severe TR to alleviate symptoms and prevent right ventricular dysfunction.
• The de Vega annuloplasty technique has been utilized for TR, but its long-term efficacy and safety require continued evaluation.

Purpose of the Study:

• To evaluate the safety and efficacy of the de Vega annuloplasty for treating predominant tricuspid regurgitation (TR).
• To assess the impact of tricuspid annuloplasty on functional status and right ventricular overload in patients with TR.
• To analyze early and late outcomes, including mortality and complications, associated with the de Vega annuloplasty procedure.

Main Methods:

• A retrospective analysis of 76 patients who underwent tricuspid annuloplasty (TA) between 1976 and 1979 for predominant tricuspid regurgitation (TR).
• The de Vega annuloplasty technique (original or modified) was applied, with TR being primarily functional in 70 patients.
• Patient data including preoperative functional class, cardiac index, atrial fibrillation status, pulmonary vascular resistance, and follow-up outcomes were collected and analyzed.

Main Results:

• The majority of TR cases were functional (70/76), often associated with mitral valve disease.
• Postoperative follow-up at 6 months showed significant improvement, with 64 of 72 patients experiencing at least a one-class improvement in functional status.
• There were 3 early and 6 late deaths, none attributed to the annuloplasty procedure, and complications directly related to TA were minimal (1 early, 2 late).

Conclusions:

• The de Vega annuloplasty is a safe and effective surgical option for treating functional tricuspid regurgitation (TR).
• The procedure demonstrates significant benefits in improving patient functional class and preventing early postoperative right ventricular overload.
• The de Vega annuloplasty offers a valuable therapeutic approach for patients suffering from TR, particularly when secondary to other valvular pathologies.