Tricuspid valve repair: is ring annuloplasty superior?†

Guenther, Thomas; Mazzitelli, Domenico; Noebauer, Christian; Hettich, Ina; Tassani-Prell, Peter; Voß, Bernhard; Lange, Rüediger

doi:10.1093/ejcts/ezs266

Cited by 63 publications

(55 citation statements)

References 16 publications

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“…3 Despite improved understanding of FTR and its surgical management, reports of late survival associated with FTR are limited. Guenther et al showed that 10-year survival after tricuspid annuloplasty (TAP) was 46%, 4 and Pfannmuller et al showed that 5-year survival was approximately 60%. 5 Persistent FTR after mitral prosthetic replacement is reported to be a risk factor for postoperative congestive heart failure and late mortality.…”

Section: Methodsmentioning

confidence: 99%

Late Outcome of Tricuspid Annuloplasty Using a Flexible Band/Ring for Functional Tricuspid Regurgitation

Fukunaga

Okada

Konishi

et al. 2015

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp plasty ring over suture annuloplasty. 4, 9 We have consistently performed TAP using a flexible ring or band for >10 years.This study assessed late survival and freedom from recurrent or progressive FTR following TAP for FTR. Additionally, the effect of residual TR on late outcome was investigated. MethodsThis retrospective study was approved by the institutional review board. We retrospectively reviewed the medical records of 220 patients (mean age, 65.4±11.4 years; range, 16-83 years) who underwent TAP for FTR in the setting of mitral valve surgery at Kobe City Medical Center General Hospital between January 2000 and December 2010. Of 220 patients, 160 (72.7%) underwent mitral valve repair (MVP), and 60 (27.3%) underwent mitral valve replacement (MVR). Patient preoperative characteristics are listed in Table 1. With regard to mitral etiology, degenerative entities comprised 94% in patients who had MVP, and rheumatic disease accounted for 87% in those unctional tricuspid regurgitation (FTR) mainly occurs because of tricuspid annular dilation and right ventricular enlargement and/or right ventricular dysfunction in mitral valve diseases. 1,2 FTR causes further right ventricular dilatation, dysfunction, or more annular dilatation, subsequently worsening FTR. 1 Increasing severity of FTR is associated with poor survival in healthy men irrespective of left ventricular function or pulmonary hypertension. 3 Despite improved understanding of FTR and its surgical management, reports of late survival associated with FTR are limited. Guenther et al showed that 10-year survival after tricuspid annuloplasty (TAP) was 46%, 4 and Pfannmuller et al showed that 5-year survival was approximately 60%. 5 Persistent FTR after mitral prosthetic replacement is reported to be a risk factor for postoperative congestive heart failure and late mortality. 6 In redo series of mitral valve surgery, persistent FTR had a negative effect on late survival. 7 FTR after TAP in redo valvular surgery also affected late outcome. 8 Evidence supports the superiority of TAP with an annulo- We assessed late outcome after tricuspid annuloplasty (TAP) using a flexible band or ring for functional tricuspid regurgitation (FTR).

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Section: Methodsmentioning

confidence: 99%

Late Outcome of Tricuspid Annuloplasty Using a Flexible Band/Ring for Functional Tricuspid Regurgitation

Fukunaga

Okada

Konishi

et al. 2015

Circ J

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“…Существует немало работ, посвященных сравнению эф-фективности данных хирургических подходов, основным критерием оценки которой является появление возврат-ной ТР в отдаленном послеоперационном периоде [12, 16-18, 20, 24]. Все виды вмешательств демонстрируют удовлетворительные непосредственные результаты, обе-спечивая хорошую замыкательную функцию ТК, однако показатели свободы от реопераций в отдаленном периоде существенно выше при использовании опорных колец (83-94,8% против 39-87,9% при шовной пластике), что позволяет считать имплантационные методики наиболее эффективным способом коррекции ФНТК [12,24].…”

Section: таблица 2 динамика показателей эхокг после хирургической коunclassified

Use of biological support rings «NeoCor» for functional tricuspid insufficiency

Odarenko¹,

Bedin²,

Rutkovskaya³

et al. 2015

Kardiol. serdechno-sosud. khir.

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Функциональная недостаточность трикуспидального клапана (ФНТК) характеризуется наличием регургитации на клапане при отсутствии поражений его створок или хордально-папиллярного аппарата. Функциональная три-куспидальная регургитация (ТР) обусловлена дилатацией правого атриовентрикулярного фиброзного кольца, воз-никающей, как правило, в результате ремоделирования правого желудочка при хронической перегрузке давлени-ем и/или объемом [11]. ФНТК является довольно распро-страненным явлением, наблюдаемым при дисфункциях митрального (МК) или аортального (АК) клапанов, а ее сохранение либо прогрессирование после хирургических вмешательств на клапанах левых отделов сердца ассоции-рованы с неблагоприятным прогнозом у большинства па-циентов [14,15,19,22].Отсутствие деструктивных изменений трикуспидаль-ного клапана (ТК) при функциональной ТР делает воз-можным выполнение клапансохраняющих хирургических операций [5]. Однако следует отметить, что определение показаний для оперативной коррекции ФНТК на разных

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“…FTR is primarily treated with a valve reconstruction that carries a much lower operative risk than valve replacement [15,25]; however, there is still a heated debate regarding the superior method of repair (either suture based or a prosthetic ring annuloplasty). McCarthy [26] reported that both flexible bands and rigid planner rings had much less recurrent TR than the De Vega procedures.…”

Section: Tablementioning

confidence: 99%

“…Tricuspid valve replacement, which allows adequate surface area of co-aptation impossible, is associated with higher mortality [13,14]. Several studies have shown better long-term freedom from recurrent TV regurgitation and repeat operation in those who underwent TV repair [15][16][17][18][19][20]; however, data regarding the outcome of such an approach and the optimal surgical technique for TV repair is lacking [6,21]. …”

Section: Introductionmentioning

confidence: 99%