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Comparative Study
. 2013;40(1):34-41.

Recurrent tricuspid insufficiency: is the surgical repair technique a risk factor?

Ibrahim Kara  1 , Cengiz Koksal, Canturk Cakalagaoglu, Muslum Sahin, Mehmet Yanartas, Yasin Ay, Serdar Demir
Affiliations
Comparative Study

Recurrent tricuspid insufficiency: is the surgical repair technique a risk factor?

Ibrahim Kara et al. Tex Heart Inst J. 2013.

Abstract

This study compares the medium-term results of De Vega, modified De Vega, and ring annuloplasty techniques for the correction of tricuspid insufficiency and investigates the risk factors for recurrent grades 3 and 4 tricuspid insufficiency after repair. In our clinic, 93 patients with functional tricuspid insufficiency underwent surgical tricuspid repair from May 2007 through October 2010. The study was retrospective, and all the data pertaining to the patients were retrieved from hospital records. Functional capacity, recurrent tricuspid insufficiency, and risk factors aggravating the insufficiency were analyzed for each patient. In the medium term (25.4 ± 10.3 mo), the rates of grades 3 and 4 tricuspid insufficiency in the De Vega, modified De Vega, and ring annuloplasty groups were 31%, 23.1%, and 6.1%, respectively. Logistic regression analysis revealed that chronic obstructive pulmonary disease, left ventricular dysfunction (ejection fraction, < 0.50), pulmonary artery pressure ≥60 mmHg, and the De Vega annuloplasty technique were risk factors for medium-term recurrent grades 3 and 4 tricuspid insufficiency. Medium-term survival was 90.6% for the De Vega group, 96.3% for the modified De Vega group, and 97.1% for the ring annuloplasty group. Ring annuloplasty provided the best relief from recurrent tricuspid insufficiency when compared with DeVega annuloplasty. Modified De Vega annuloplasty might be a suitable alternative to ring annuloplasty when rings are not available.

Keywords: Clinical trial; regression analysis; surgery/techniques; treatment outcome; tricuspid valve insufficiency/complications/etiology/surgery; tricuspid valve/surgery.

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Figures

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Fig. 1 Drawings show annuloplasty of the tricuspid valve by the A) De Vega, B) modified De Vega, and C) ring techniques.
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Fig. 2 Graph shows freedom from recurrent grades 3 and 4 tricuspid insufficiency for the 3 surgical groups. Note especially the mid-term follow-up.
See this image and copyright information in PMC

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