Korean J Thorac Cardiovasc Surg.  2018 Apr;51(2):92-99. 10.5090/kjtcs.2018.51.2.92.

Early Clinical Outcomes of Tricuspid Valve Repair with a Tri-Ad Annuloplasty Ring in Comparison with the Outcomes Using an MC³ Ring

• Jung W
• Choi JW
• Hwang HY
• Kim KH

• KMID: 2409692
• DOI: http://doi.org/10.5090/kjtcs.2018.51.2.92

Abstract

BACKGROUND
We evaluated the early clinical outcomes of tricuspid valve annuloplasty (TAP) with the Tri-Ad annuloplasty ring for functional tricuspid regurgitation (TR).
METHODS
From January 2015 to March 2017, 36 patients underwent TAP with a Tri-Ad ring for functional TR. To evaluate the early clinical outcomes of TAP with the Tri-Ad ring, we conducted a propensity score-matched analysis comparing the Tri-Ad and MC3 tricuspid annuloplasty rings (n=34 in each group). The follow-up duration was 11.0±7.07 months.
RESULTS
There was 1 case of operative mortality (2.8%) and no cases of late mortality. Postoperative complications occurred in 15 patients (41%), including acute kidney injury in 6 patients (16%), bleeding requiring reoperation in 4 patients (11%), and low cardiac output syndrome in 4 patients (11%). There were no ring-related complications, such as atrioventricular block or ring dehiscence. The TR grade decreased significantly (from 2.03±1.06 to 1.18±0.92, p < 0.01), as did the systolic pulmonary artery pressure (from 43.53±13.84 to 38.00±9.72 mm Hg, p=0.03). There were no cases of severe residual TR, but moderate TR was observed in 3 patients, all of whom had severe TR preoperatively. Severe preoperative TR was also associated with moderate in the univariate analysis (p < 0.01). In the propensity score-matched analysis comparing the Tri-Ad and MC3 rings, there was no significant difference in early clinical outcomes.
CONCLUSION
TAP with the Tri-Ad ring corrected functional TR effectively and provided good early clinical and echocardiographic results without ring-related complications. However, severe preoperative TR was associated with moderate or severe residual TR in the immediate postoperative period. A follow-up study is necessary to confirm the stability of this procedure.

Keyword

Tricuspid valve; Tricuspid valve insufficiency; Cardiac valve annuloplasty

MeSH Terms

Acute Kidney Injury
Atrioventricular Block
Cardiac Output, Low
Cardiac Valve Annuloplasty
Echocardiography
Follow-Up Studies
Hemorrhage
Humans
Mortality
Postoperative Complications
Postoperative Period
Pulmonary Artery
Reoperation
Tricuspid Valve Insufficiency
Tricuspid Valve*