Kay annuloplasty of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation

Abstract

Objective Ideal management of functional tricuspid regurgitation (TR) has been a matter of debate for a long time. We try to discuss the midterm results with tricuspid Kay annuloplasty versus ring tricuspid annuloplasty for the treatment of functional TR. Patients and methods From January 2015 to January 2019, 82 patients underwent tricuspid annuloplasty for functional TR as part of their cardiac surgical procedure. Kay annuloplasty was performed in 55 patients and ring annuloplasty in 27 patients. Preoperatively, patients had moderate or greater TR with a median regurgitation of +3. Follow-up information was obtained for the patients with a mean follow-up time of 3 years. Postoperative transthoracic echocardiograms were assessed for severity of TR. Moderate or greater TR was considered significant. Survival and development of recurrent TR were evaluated by transthoracic echocardiograms analysis. TR and risk factors for recurrent regurgitation were identified and analyzed. Results At 3 years postoperatively, TR in patients treated by Kay annuloplasty was zero to mild in 75%, moderate in 11%, moderate to severe in 6%, and severe in 8% of patients. In those undergoing ring annuloplasty, TR was zero to mild in 69%, moderate in 14%, moderate to severe in 7%, and severe in 10%. There was no significant difference between the two groups. Risk factors for recurrent TR included higher preoperative regurgitation grade, preoperative TR without concomitant mitral regurgitation, and higher pulmonary artery systolic pressure. Conclusion Kay annuloplasty and ring annuloplasty were effective in eliminating TR at 3 years postoperatively. Kay annuloplasty is a simple, inexpensive option for addressing functional TR. All patients with moderate-to-severe functional TR should undergo tricuspid annuloplasty regardless of the technique used.