Impact of the degree of tricuspid valve tethering on the early outcome of tricuspid valve repair with the De-Vega technique

Abstract

Background: Functional tricuspid regurgitation (TR) is usually caused by leaflet tethering, and annuloplasty is usually recommended to repair annulus dilatation. This work aimed to evaluate the impact of the degree of the tricuspid valve (TV) tethering on the early outcome of tricuspid valve repair with the De-Vega technique.
 Methods: This prospective study included 50 patients with De-Vega tricuspid valve repair. Patients were divided into two groups; Group A (n= 25) included patients with tricuspid valve tethering of 8 mm or less, and Group B (n= 25) included patients with tricuspid valve tethering distance of more than 8 mm.
 Results: The mean age of Group A was 46.1 ±3.5 years compared to 49.6 ±7 years in Group B. There were significant differences in postoperative ejection fraction (48.7 ±12.5 vs. 39.1 ±9.4 %, P= 0.003), TV tethering distance (0.6 ±0.2 vs. 1.1 ±0.4 cm, P <0.001), and area (1.1 ±0.5 vs. 2.6 ±0.9 cm2; P<0.001), and right ventricle fractional area (32.2± 7.9 vs. 25.4 ±9.7 cm2, P= 0.008) in Group A vs. B, respectively. There were no differences in postoperative complications, ICU, and hospital stay between groups.
 Conclusion: Residual tricuspid regurgitation after De-Vega annuloplasty could be related to TV tethering distance. Increased TV tethering distance could be associated with reduced postoperative ejection fraction.