Abstract
This study aimed to evaluate the outcomes of tricuspid annuloplasty with/without additional edge-to-edge plications in patients with functional tricuspid regurgitation and to clarify the impact of tethering on surgical outcomes. This retrospective observational study included patients with moderate or greater functional tricuspid regurgitation who underwent initial tricuspid valve repair between January 2008 and December 2021. The patients were divided into two groups based on whether they had tethering (preoperative tethering area ≥0.75 cm2). All patients underwent annuloplasty, and edge-to-edge plications were added at the regurgitant leakage site identified by saline tests. The surgical outcomes of each group, and the effect of tethering on recurrent moderate or greater tricuspid regurgitation were evaluated. One-hundred and thirty-three patients were included in this study. During the follow-up period of 55.3 (standard deviation: 44.9) months, the 5-year survival rates were 78.4% in patients without tethering and 76.1% in patients with tethering (P = 0.78). The 5-year cumulative incidence rates of readmission for heart failure and recurrent tricuspid regurgitation were 10.8% and 1.3% in patients without tethering and 23.0% and 29.5% in patients with tethering, respectively (P = 0.12 and <0.001). Multivariable analyses revealed that the preoperative and predischarge tethering areas predicted recurrent tricuspid regurgitation. A large tethering area remained postoperatively in patients with tethering. In patients without tethering, annuloplasty and additional edge-to-edge plications are effective in avoiding recurrent tricuspid regurgitation with satisfactory midterm clinical outcomes. However, in patients with tethering, these procedures resulted in residual tethering, which could be leading to recurrent tricuspid regurgitation.
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Schedule a callMore From: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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