Long-Term Outcomes of Suture vs. Ring Tricuspid Annuloplasty for Functional Tricuspid Regurgitation

Hata, Hiroyuki; Fujita, Tomoyuki; Miura, Sayaka; Shimahara, Yusuke; Kume, Yuta; Matsumoto, Yorihiko; Yamashita, Kizuku; Kobayashi, Junjiro

doi:10.1253/circj.cj-17-0108

Cited by 20 publications

(12 citation statements)

References 28 publications

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“…The impact of age on TR progression was previously investigated. A study by Hata et al 17) revealed that older age was independent risk factor of recurrent moderate-to-severe TR. Kusajima et al 7) reported that age has an independent but minor impact on TR progression, with an OR of 1.1.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Mitral Valve Repair versus Replacement for the Progression of Functional Tricuspid Regurgitation

Gao

Zhuang

et al. 2020

ATCS

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Background: Function tricuspid regurgitation (TR) is frequently observed in patients undergoing mitral valve surgery. It is unclear that mitral valve repair (MVr) or mitral valve replacement (MVR) has influence on the likelihood of late TR progression. Methods: This study included 193 patients with degenerative mitral valve disease who underwent either MVr or MVR. Detailed preoperative materials, follow-up information, and echocardiographic data were collected and statistically analyzed. Results: At 6 and 12 months postoperatively, MVR patients were more likely to have New York Heart Association (NYHA) class III or IV symptoms than MVr patients (6 mo: 15.2% vs 5.0%, 12 mo: 13.0% vs 4.0%, both P <0.05). At 24 months, the incidence of Grade 1+ TR was significantly higher in MVR patients than MVr patients (25.0% vs 12.9%, P <0.05). In univariate analysis, age (odds ratio [OR] = 1.036, P = 0.036), MVR (OR = 2.256, P = 0.033), and preoperative TR area (TRA; OR = 1.541, P = 0.047) were significant predictors for TR progression. In multivariate logistics analysis, only MVR was independently risk factor (P = 0.006). Subsequently, patients were divided into tricuspid valve repair (TVr) group and untreated group. In both subgroups, MVR patients were associated with significantly larger TRA (P <0.01). Conclusion: MVR was an independent risk factor for TR progression, whether tricuspid valve was treated or not.

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Section: Discussionmentioning

confidence: 99%

Comparison of Mitral Valve Repair versus Replacement for the Progression of Functional Tricuspid Regurgitation

Gao

Zhuang

et al. 2020

ATCS

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“…De Vega suture annuloplasty has been abandoned most Institutions and in many reports provides worse results than other device 37‐40 . However, some studies showed similar results between De Vega suture annuloplasty and ring 32,33,41 . Nevertheless, in our experience De Vega suture annuloplasty, technically, has not lower freedom from TR return than use of bands or rings.…”

Section: Discussionmentioning

confidence: 49%

“…Whether the surgical technique could influence TR recurrence remains debated 30‐33 . In our experience, no difference was observed according to the surgical strategy.…”

Section: Discussionmentioning

confidence: 57%

Late tricuspid regurgitation and right ventricular remodeling after tricuspid annuloplasty

et al. 2020

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Background The aim of the present retrospective study was to evaluate the influence of preoperative right ventricular (RV) and tricuspid valve (TV) remodeling on the fate of tricuspid annuloplasty (TA) and right ventricle. Methods From May 2009 to December 2015, 423 patients who had undergone TA for functional tricuspid regurgitation (TR) were included in the study. Residual and recurrent TR were defined as moderate or more TR at discharge and follow‐up, respectively. RV remodeling was defined as RV dysfunction and/or dilation. Results Residual TR after TA was recorded in 54 patients (13%). Five‐year freedom from TR recurrence was 81% ± 3% in patients without residual TR and 41 ± 8 in patients with residual TR (P < .001). In patients without residual TR, the following risk factors for recurrent TR and late RV remodeling were identified: preoperative systolic pulmonary artery pressure, preoperative RV remodeling, severe preoperative TR or less than severe TR but with TV apparatus remodeling, and etiology of mitral regurgitation. Cox analysis with time‐dependent variables confirmed TR recurrence (hazard ratio [HR]: 3.1) and late RV remodeling (HR: 6.5) as risk factors for lower survival. No protective effect of either flexible band or rigid ring TA compared with DeVega procedure was found. Similarly, preoperative atrial fibrillation and pacemaker dependency, late failure of mitral valve surgery did not affect the fate of TR. Conclusions Prophylactic TA should be encouraged among surgeons. TA at the time of left‐sided valve surgery should take into consideration not only annular size, but also tethering severity and RV remodeling.

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“…Whether the surgical technique used for TAP could affect surgical results remains a matter of debate . Many studies support the use of rigid, or flexible devices, or report similar results with suture annuloplasty vs flexible or rigid devices, or with flexible vs rigid devices .…”

Section: Discussionmentioning

confidence: 99%

Early failure of tricuspid annuloplasty. Should we repair the tricuspid valve at an earlier stage? The role of right ventricle and tricuspid apparatus

et al. 2019

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Background: We sought to identify subgroups of patients at a higher probability of tricuspid annuloplasty (TAP) failure early after surgery.Methods: From May 2009 to December 2015, 688 patients undergoing TAP for functional tricuspid regurgitation (FTR) at a single institution were included in the study. In all patients, a complete transthoracic echocardiographic evaluation of right ventricle (RV) and tricuspid valve (TV) apparatus was collected.Results: Twenty-six patients (3.8%) died within the first 30 days of surgery. Residual TR after TAP was recorded in 85 (12.4%), moderate in 80 (11.7%) and severe in 5 (0.7%). Preoperative TV apparatus remodeling was associated with residual TR; in particular, the following cutoffs were identified: TV coaptation depth ≥6.5 mm, tenting area ≥0.85 cm 2 , and tricuspid annulus ≥35 mm. The entire cohort was stratified in three subsets: patients having preoperative mild/moderate TR without preoperative TV apparatus and/or RV remodeling (n = 178); patients having mild/ moderate TR with TV apparatus and/or RV remodeling (n = 317); patients with severe TR regardless of TV apparatus and/or RV remodeling (n = 193). Residual TR was 2.8%, 10.4%, and 24.3%, respectively (P < 0.001). At multivariable analysis, patients showing preoperative mild/moderate TR with TV apparatus and/or RV remodeling as well as patients with severe TR were at significantly higher risk for early failure. No difference was found regarding the type of TV repair performed.Conclusions: Prophylactic TAP should be encouraged among surgeons even earlier than guidelines recommend, and decision-making for the treatment of low-grade FTR at the time of left-sided valve surgery should take into consideration not only annular size but also tethering severity and RV dilatation. K E Y W O R D S right ventricular remodeling, tricuspid annuloplasty, tricuspid regurgitation J Card Surg. 2019;34:404-411. wileyonlinelibrary.com/journal/jocs 404 |

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Long-Term Outcomes of Suture vs. Ring Tricuspid Annuloplasty for Functional Tricuspid Regurgitation

Cited by 20 publications

References 28 publications

Comparison of Mitral Valve Repair versus Replacement for the Progression of Functional Tricuspid Regurgitation

Comparison of Mitral Valve Repair versus Replacement for the Progression of Functional Tricuspid Regurgitation

Late tricuspid regurgitation and right ventricular remodeling after tricuspid annuloplasty

Early failure of tricuspid annuloplasty. Should we repair the tricuspid valve at an earlier stage? The role of right ventricle and tricuspid apparatus

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