Abstract
Background: Tricuspid valve (TV) repair is the recommended treatment for severe functional tricuspid regurgitation (fTR) in patients undergoing left-sided surgery. For this purpose, a wide range of annuloplasty devices differing in form and flexibility are available. This study reports the results using a three-dimensional annuloplasty ring (Medtronic, Contour 3D Ring) for TV repair and analysis of risk factors. Methods: A cohort of 468 patients who underwent TV repair (TVr) with a concomitant cardiac procedure from December 2010 to January 2017 was retrospectively analyzed. Results: At follow-up, 96.1% of patients had no/trivial or mild TR. The 30-day mortality was 4.7%; it significantly differed between electively performed operations (2.7%) and urgent/emergent operations (11.7%). Risk factors for recurrent moderate and severe TR were LVEF < 50%, TAPSE < 16 mm, and moderate mitral valve (MV) regurgitation at follow-up. Preoperatively reduced renal function lead to a higher 30-day and overall mortality. Reoperation of the TV was required in six patients (1.6%). Risk factors for TV related reoperations were preoperative TV annulus over 50 mm and an implanted permanent pacemaker. Conclusions: TVr with the Contour 3D annuloplasty ring shows low TR recurrence and reoperation rates. Risk-factor analysis for the recurrence of TR revealed the importance of left- and right-ventricular function.
Highlights
The surgical treatment of functional tricuspid valve (TV) regurgitation has moved into the spotlight since numerous studies have shown that untreated tricuspid regurgitation (TR) during left-sided valve surgery leads to progressive TR and increased mortality [1,2,3,4]
This study presents a retrospective analysis of all consecutive patients, who underwent TV repair (TVr) for functional tricuspid regurgitation (fTR) with the Contour 3D annuloplasty ring with concomitant cardiac procedures at the German Heart Center Munich between December 2010 and January 2017
The implantation of the rigid, three-dimensional Contour 3D annuloplasty ring for TVr results in good outcomes in regard to the recurrence of TR, which are comparable to other 3D and plane annuloplasty devices
Summary
The surgical treatment of functional tricuspid valve (TV) regurgitation has moved into the spotlight since numerous studies have shown that untreated tricuspid regurgitation (TR) during left-sided valve surgery leads to progressive TR and increased mortality [1,2,3,4]. Tricuspid valve (TV) repair is the recommended treatment for severe functional tricuspid regurgitation (fTR) in patients undergoing left-sided surgery. For this purpose, a wide range of annuloplasty devices differing in form and flexibility are available. Risk factors for recurrent moderate and severe TR were LVEF < 50%, TAPSE < 16 mm, and moderate mitral valve (MV) regurgitation at follow-up. Risk-factor analysis for the recurrence of TR revealed the importance of left- and right-ventricular function
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