Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2014
Long-term outcomes of tricuspid annuloplasty for functional tricuspid regurgitation associated with degenerative mitral regurgitation: suture annuloplasty versus ring annuloplasty using a flexible band.
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Murashita Takashi, Okada Yukikatsu, Kanemitsu Hideo, Fukunaga Naoto, Konishi Yasunobu, Nakamura Ken, Koyama Tadaaki
Аннотация
PURPOSE: We investigated the long-term outcomes of suture/ring tricuspid valve annuloplasty for functional tricuspid regurgitation associated with degenerative mitral regurgitation.
METHODS: We retrospectively reviewed patients who underwent flexible ring tricuspid valve annuloplasty (n = 120) or suture tricuspid valve annuloplasty (n = 42) for functional tricuspid regurgitation concomitant with surgery for degenerative mitral regurgitation (mean follow-up duration, 5.3 ± 5.1 years).
RESULTS: The mean age of patients was 62.5 ± 13.1 years. Thirty-day mortality was zero in the suture group, and 0.8% in the ring group. Tricuspid regurgitation grade at discharge was lower in the ring group ( p = 0.002). No difference was observed between survival and freedom from major cardiac/cerebrovascular adverse events between the groups. However, freedom from ≥moderate tricuspid regurgitation was higher in the ring group (Log-rank p = 0.003). From univariate analysis, the risk factors for ≥moderate TR were suture annuloplasty and preoperative tricuspid regurgitation grade. No reoperation for recurrent tricuspid regurgitation occurred in either group because symptoms experienced by patients with recurrent tricuspid regurgitation were relatively insignificant.
CONCLUSION: Concomitant tricuspid annuloplasty using flexible bands offered improved durability than suture annuloplasty for preventing postoperative tricuspid regurgitation progression.
METHODS: We retrospectively reviewed patients who underwent flexible ring tricuspid valve annuloplasty (n = 120) or suture tricuspid valve annuloplasty (n = 42) for functional tricuspid regurgitation concomitant with surgery for degenerative mitral regurgitation (mean follow-up duration, 5.3 ± 5.1 years).
RESULTS: The mean age of patients was 62.5 ± 13.1 years. Thirty-day mortality was zero in the suture group, and 0.8% in the ring group. Tricuspid regurgitation grade at discharge was lower in the ring group ( p = 0.002). No difference was observed between survival and freedom from major cardiac/cerebrovascular adverse events between the groups. However, freedom from ≥moderate tricuspid regurgitation was higher in the ring group (Log-rank p = 0.003). From univariate analysis, the risk factors for ≥moderate TR were suture annuloplasty and preoperative tricuspid regurgitation grade. No reoperation for recurrent tricuspid regurgitation occurred in either group because symptoms experienced by patients with recurrent tricuspid regurgitation were relatively insignificant.
CONCLUSION: Concomitant tricuspid annuloplasty using flexible bands offered improved durability than suture annuloplasty for preventing postoperative tricuspid regurgitation progression.
Предметные рубрики MeSH
AgedCardiac Valve AnnuloplastyDisease-Free SurvivalFemaleHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHumansJapanMaleMiddle AgedMitral ValveMitral Valve InsufficiencyPostoperative ComplicationsProsthesis DesignRecurrenceRetrospective StudiesSeverity of Illness IndexSuture TechniquesTime FactorsTreatment OutcomeTricuspid ValveTricuspid Valve Insufficiency