BACKGROUND: The purpose of this study was to compare the long-term results of tricuspid valve (TV) repair with or without an annuloplasty ring. METHODS AND RESULTS: 702 patients underwent TV repair at our institution (1978 to 2003), of which 493 had, predominantly, a De Vega procedure (no ring) and 209 had an annuloplasty ring (ring). TV pathology was functional (secondary) in 74% of patients. Concomitant procedures consisted of mitral valve surgery in 80% of patients, aortic valve surgery in 33%, and coronary bypass in 14%. Clinical and echocardiographic follow-up data were obtained. Follow-up was 99% complete and was 5.9+/-4.9 (mean+/-SD) years long. Ring patients were younger (55+/-14 versus 59+/-14 years; P=0.001) and less likely to have coronary artery disease (10% versus 17%; P=0.02), more likely to be female (75% versus 65%; P=0.01) and having had previous cardiac surgery (56% versus 42%; P=0.001). Operative times were similar between the 2 groups. Long-term survival, event-free survival and freedom from recurrent TR were significantly better in the ring group, and there was a trend toward fewer TV reoperations. Multivariable analysis demonstrated that the use of an annuloplasty ring was an independent predictor of long-term survival (hazard ratio [HR], 0.7; 95% confidence interval [CI], 0.5 to 1.0; P=0.03) and event-free survival (HR, 0.8; CI, 0.6 to 1.0; P=0.04). CONCLUSIONS: Placement of an annuloplasty ring in patients undergoing tricuspid valve repair is associated with improved survival and event-free survival.
BACKGROUND: The purpose of this study was to compare the long-term results of tricuspid valve (TV) repair with or without an annuloplasty ring. METHODS AND RESULTS: 702 patients underwent TV repair at our institution (1978 to 2003), of which 493 had, predominantly, a De Vega procedure (no ring) and 209 had an annuloplasty ring (ring). TV pathology was functional (secondary) in 74% of patients. Concomitant procedures consisted of mitral valve surgery in 80% of patients, aortic valve surgery in 33%, and coronary bypass in 14%. Clinical and echocardiographic follow-up data were obtained. Follow-up was 99% complete and was 5.9+/-4.9 (mean+/-SD) years long. Ring patients were younger (55+/-14 versus 59+/-14 years; P=0.001) and less likely to have coronary artery disease (10% versus 17%; P=0.02), more likely to be female (75% versus 65%; P=0.01) and having had previous cardiac surgery (56% versus 42%; P=0.001). Operative times were similar between the 2 groups. Long-term survival, event-free survival and freedom from recurrent TR were significantly better in the ring group, and there was a trend toward fewer TV reoperations. Multivariable analysis demonstrated that the use of an annuloplasty ring was an independent predictor of long-term survival (hazard ratio [HR], 0.7; 95% confidence interval [CI], 0.5 to 1.0; P=0.03) and event-free survival (HR, 0.8; CI, 0.6 to 1.0; P=0.04). CONCLUSIONS: Placement of an annuloplasty ring in patients undergoing tricuspid valve repair is associated with improved survival and event-free survival.
Authors: M Y Emmert; R Pretre; S Suendermann; B Weber; D A Bettex; S P Hoerstrup; V Falk Journal: Clin Res Cardiol Date: 2010-09-15 Impact factor: 5.460
Authors: Julius I Ejiofor; Robert C Neely; Maroun Yammine; Siobhan McGurk; Tsuyoshi Kaneko; Marzia Leacche; Lawrence H Cohn; Prem S Shekar Journal: Ann Cardiothorac Surg Date: 2017-05
Authors: Eric N Feins; Yuhan Lee; Eoin D O'Cearbhaill; Nikolay V Vasilyev; Shogo Shimada; Ingeborg Friehs; Douglas Perrin; Peter E Hammer; Haruo Yamauchi; Gerald Marx; Andrew Gosline; Veaceslav Arabagi; Jeffrey M Karp; Pedro J Del Nido Journal: Nat Biomed Eng Date: 2017-10-10 Impact factor: 25.671