Mid-term results of three dimensional annuloplasty ring repair in treating functional tricuspid valve regurgitation

Background

Functional tricuspid regurgitation (TR) is caused by annular dilatation mainly in the posterior annulus. However, ring annuloplasty does not always prevent the recurrence of TR. Tricuspid repair with 3-dimensional Contour 3D ring is claimed to improve functional TR yet the mid and long-term results of repair need to be assessed.

Methods

From March 2013 to March 2015, 50 patients with Functional TR secondary to left-sided valve disease underwent tricuspid annuloplasty using the Contour 3D (Medtronic, Minneapolis, MN) ring. All patients underwent concomitant left-sided valve surgery. Follow-up of TR and right ventricular (RV) function were done before hospital discharge and after 12 and 24 months.

Results

Mean ring size was 30.5 mm (range 28–36). Hospital mortality was 4%. The follow-up period was 26 ± 6 months. Echocardiography at hospital discharge documented no or mild, moderate, and moderate to severe TR in 76%, 16% and 4% of the patients respectively. Follow-up after one year revealed mild TR in 16% of patients, moderate TR in 16% patients. At 24 months, moderate TR was present in 12% patients, no patient had any evidence of severe TR at 12 and 24 months. Freedom from TR≥ +3 was 100% after 24 months.

Conclusions

Tricuspid annuloplasty with the Contour 3D ring provided satisfactory early results in functional TR which remained stable at mid-term follow up. Still long-term results need further follow up and assessment.