Tricuspid Annuloplasty for Tricuspid Regurgitation Secondary to Left-Sided Heart Valve Disease: Immediate Outcomes and Risk Factors for Late Failure

Determinants of recurrent tricuspid regurgitation following tricuspid valve annuloplasty during mitral valve surgery

“…Although preoperative functional MR were not a statistically significant predictor of late TR progression, most of the recurrent MR in the patients with TR progression were due to tethering of the MV leaflets and/or annular dilatation. Gatti and colleagues demonstrated that a newly developed left‐sided valvular lesion was present in 40% of patients with late TR progression (odds ratio: 5.3; 95%CI: 2.5‐11), which was similar to our results …”

“…TVA using annuloplasty bands or rings is reportedly associated with improved late TR progression compared to suture annuloplasty; however, the superiority of flexible bands or rigid rings over the other has long been a matter of debate. Among limited number of studies comparing the two types of annuloplasty devices, some reported there was no difference in late TR progression rate, and others reported better results in patients with rigid rings . In a study by Gatti and colleagues, there was no difference in freedom from late TR ≥ 2/3, which corresponds to ≥3/4 in our analysis, between groups (flexible vs. rigid, 96.9% vs. 93.6% at 5 years), but right atrial, tricuspid valve, and right ventricular reverse remodeling occurred following rigid rings but not flexible bands .…”

“…Tricuspid valve annuloplasty (TVA) using annuloplasty bands or rings is reported to be associated with decreased recurrent TR in comparison to suture annuloplasty; however, the superiority of flexible bands or rigid rings has long been a matter of debate. Gatti and colleagues reported no significant difference between flexible bands and rigid rings in freedom from late TR progression, whereas rigid ring annuloplasty resulted in better outcomes including improved functional class and right heart function than flexible bands in other studies …”

Pathophysiology and management of multivalvular disease

“…For the surgical treatment of tricuspid regurgitation at the time of left-sided valve surgery, the preferred technique is tricuspid annuloplasty given that the tricuspid regurgitation is most often due to annulus dilation with ensuing lack of leaflet coaptation and that tricuspid valve replacement is associated with a higher rate of complications compared to annuloplasty 34, 81, 90, 91 …”

Factors Affecting Longevity of Tricuspid Valve Repair.

“…Gatti et al reported an improvement in tricuspid valve dilatation after surgery,with respect to TR, with the estimated freedom from all-cause death being 77.8% for 10 years. [2] McCarthy et al reported the experience of the Cleveland Clinics in tricuspid valve repairs in 2004. They showed a high level of early recurrence of significant TR (14%) a week after tricuspid valve repair.…”