Undersized Tricuspid Annuloplasty Rings Optimally Treat Functional Tricuspid Regurgitation

Long-Term Outcomes of Tricuspid Annuloplasty for Functional Tricuspid Regurgitation Associated with Degenerative Mitral Regurgitation: Suture Annuloplasty Versus Ring Annuloplasty Using a Flexible Band

“…In our surgery, however, we always implant the annuloplasty ring by placing sutures along the anterior, posterior, and right half of the septal annulus. This implantation method has also been supported by a previous report 9) and is not a risk factor for pacemaker implantation. This implantation technique, in which sutures are also placed on the right half of the septal annulus, could be a reason why there has been less TR progression than in other reports.…”

“…Ghoreishi, et al and Jeong, et al reported successful outcomes for TV annuloplasty using undersized rigid 3-dimensional annuloplasty rings. 9,10) Benedetto, et al reported on a randomized study hypothesizing whether TV annuloplasty should be added prophylactically at the time of MV surgery, and concluded that prophylactic TV annuloplasty using a flexible ring in patients with dilated tricuspid annulus was associated with a decreased incidence of TR progression. 11) Izutani, et al reported on a retrospective study that compared the outcomes of using flexible bands and rigid rings 12) and concluded that although both flexible band and rigid ring annuloplasty provided a low incidence of TR recurrence, rigid ring annuloplasty may be more effective than flexible band annuloplasty for decreasing functional TR in immediate and mid-term postoperative periods.…”

“…However, it is not clear which procedure is superior, and the durability of each prosthetic ring has not been described. [9][10][11][12] In the early years, suture annuloplasty was usually used in TV annuloplasty procedure in our institution, but now the use of ring annuloplasty with flexible bands is predominant. Severe TR associated with degenerative MR was usually treated concomitantly with TV annuloplasty, whereas mild and moderate TR was treated on a caseto-case basis, according to the individual patient's needs.…”

Echocardiography of the tricuspid valve

“…However, ring annuloplasty with a rigid or semi rigid partial annuloplasty band is currently regarded as the standard for surgical repair as it is associated with more effective and durable reduction in TR (39). Some authors have emphasized the importance of using an "undersized" (nominal 26 or 28 mm) rigid nonplanar annuloplasty ring for optimal results (40).…”

Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence

“…Filsoufi [27] and De Bonis [8] found excellent reductions in TR severity early and mid-term after surgery with the MC 3 ring. Ghoreishi [28] showed that the rigid three-dimensional ring could be the most reliable and durable treatment for FTR. This ring annuloplasty provides an early and sustained reduction of TR secondary to LVD, which has been reported by Navia [29].…”