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Tricuspid valve annuloplasty with a flexible prosthetic band

^a Department of Cardiovascular Medicine, Divisions of Cardiac Surgery and Cardiology, Ospedali Riuniti di Trieste, Strada di Fiume 447, 34100 Trieste, Italy
^b Division of Cardiology, Ospedale Santa Maria degli Angeli, Pordenone, Italy

*Corresponding author. Tel.: +39 040 3994856; fax: +39 040 3994995.

E-mail address: giusep.gatti{at}tiscali.it (G. Gatti).

This study evaluates the application to the tricuspid valve of a flexible prosthetic band originally devised for mitral repair. Between March 2001 and May 2005, 53 consecutive patients (age 66.2±8.5 years) with significant tricuspid regurgitation and dilatation of the right-sided cardiac chambers underwent tricuspid valve annuloplasty with the band and concomitant mitral repair or replacement. Thirty-one patients (58.5%) were in NYHA class III or IV, and 33 (62.3%) had a history of right heart failure. Follow-up was 19.2±14.0 months. Three patients (5.7%) died before discharge, and one during follow-up. One late reoperation was required for mitral endocarditis. NYHA class decreased in survivors from 2.7±0.8 to 1.4±0.6 (P<0.0001), and the symptoms of right heart failure improved significantly after surgery. Tricuspid regurgitation was mild or absent in 44 survivors (89.8%) and moderate in 5 (10.2%). Regurgitation significantly decreased even in patients with risk factors for tricuspid repair failure or with persistent left ventricular dysfunction. The 4-year actuarial freedom from tricuspid regurgitation grade >1 was 88.7%. By univariable analysis, preoperative tricuspid regurgitation grade >2, right ventricular shortening fraction <35%, and permanent pacemaker were associated with the risk of recurrent moderate regurgitation, though only probably so (P=0.077, 0.061, and 0.097, respectively).

Key Words: Echocardiography; Heart valves; Mitral valve; Tricuspid valve

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