Abstract
Introduction: Tricuspid valve (TV) annuloplasty is recommended for management of functional tricuspid regurgitation (TR); however, residual TR occurs up to 25% of patients after surgery. For management of mitral regurgitation, edge-to-edge repair is accepted as effective procedure. Hypothesis: TV annuloplasty with edge-to-edge repair is more effective for management of functional TR than isolated TV annuloplasty. Methods: We analyzed 216 patients who underwent isolated TV annuloplasty and 75 patients who underwent TV annuloplasty with edge-to-edge repair. Echocardiography was performed to assess response to surgery and cardiac function and geometry 21 ± 5 days before and 6 ± 4 days after surgery. Severity of TR was assessed by maximal jet area in the right atrium. Residual TR was defined as maximal TR jet area >5 cm 2 after surgery. Results: There was no significant difference in preoperative functional TR jet area between patients who underwent isolated TV annuloplasty and those who underwent TV annuloplasty with edge-to-edge repair (Table). Patients who underwent isolated TV annuloplasty showed significantly greater TV annulus diameter and lower right ventricular fractional area shortening than those who underwent TV annuloplasty with edge-to-edge repair. In both groups, TR jet area was significantly decreased after surgery. Patients who underwent TV annuloplasty with edge-to-edge repair showed significantly lower postoperative TR jet area as compared with those who underwent isolated TV annuloplasty although mean postoperative TR jet areas were <5 cm 2 in both groups. Patients who underwent TV annuloplasty with edge-to-edge repair showed significantly less residual TR as compared with those who underwent isolated TV annuloplasty. Conclusions: TV annuloplasty with edge-to-edge repair is effective procedure for management of functional TR and may be superior to isolated TV annuloplasty.
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