JTCS Concomitant Website
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Raymond Chen
Narendren Narayanasamy
Frederick Y. Chen
Lawrence H. Cohn
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ghanta, R. K.
Right arrow Articles by Cohn, L. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ghanta, R. K.
Right arrow Articles by Cohn, L. H.
Related Collections
Right arrowRelated Article

J Thorac Cardiovasc Surg 2007;133:117-126
© 2007 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation: Midterm results of 237 consecutive patients

Ravi K. Ghanta, MDa, Raymond Chen, MD, PhDa, Narendren Narayanasamy, MDa, Siobhan McGurk, BSa, Stuart Lipsitz, ScDb, Frederick Y. Chen, MD, PhDa, Lawrence H. Cohn, MDa,*

a Division of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass
b Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.

Read at the Eight-sixth Annual Meeting of The American Association for Thoracic Surgery, Philadelphia, Pa, April 29-May 3, 2006.

Received for publication May 5, 2006; revisions received August 10, 2006; accepted for publication August 25, 2006.

* Address for reprints: Lawrence H. Cohn, MD, Division of Cardiac Surgery, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. (Email: lcohn{at}partners.org).

OBJECTIVE: Uncorrected functional tricuspid regurgitation has serious long-term morbidity and mortality. We reviewed our experience with tricuspid posterior annular bicuspidization versus ring tricuspid annuloplasty for treatment of functional tricuspid regurgitation.

METHODS: From 1999 to 2003, 237 patients underwent tricuspid annuloplasty for functional tricuspid regurgitation as part of their cardiac surgical procedure. Bicuspidization was performed in 157 patients and ring annuloplasty in 80 patients. Preoperatively, 227 (96%) patients had moderate or greater tricuspid regurgitation with a median regurgitation of 3+. Follow-up information was obtained for 234 (99%) patients with a mean follow-up time of 3 years. Postoperative transthoracic echocardiograms were assessed for severity of tricuspid regurgitation. Moderate or greater tricuspid regurgitation was considered significant. Survival and development of recurrent tricuspid regurgitation were evaluated by Kaplan–Meier analysis. Tricuspid regurgitation and risk factors for recurrent regurgitation were identified and analyzed by multivariable ordinal longitudinal methods.

RESULTS: At 3 years postoperatively, tricuspid regurgitation in patients treated by bicuspidization annuloplasty was zero to mild in 75%, moderate in 11%, moderate to severe in 6%, and severe in 8% of patients. In those undergoing ring annuloplasty, tricuspid regurgitation was zero to mild in 69%, moderate in 14%, moderate to severe in 7%, and severe in 10%. There was no significant difference between the two groups (P = .18). Risk factors for recurrent tricuspid regurgitation included higher preoperative regurgitation grade, preoperative tricuspid regurgitation without concomitant mitral regurgitation, and higher pulmonary artery systolic pressure.

CONCLUSIONS: Bicuspidization annuloplasty and ring annuloplasty were effective at eliminating tricuspid regurgitation at 3 years postoperatively. Bicuspidization annuloplasty is a simple, inexpensive option for addressing functional tricuspid regurgitation. All patients with moderate-to-severe functional tricuspid regurgitation should undergo tricuspid annuloplasty regardless of the technique used.

Abbreviations and Acronyms ACC = American College of Cardiology; AHA = American Heart Association; AI = aortic insufficiency; EF = ejection fraction; LV = left ventricular; MR = mitral regurgitation; NYHA = New York Heart Association; PASP = pulmonary artery systolic pressure; RV = right ventricular; TR = tricuspid regurgitation


Related Article

Discussion
J. Thorac. Cardiovasc. Surg. 2007 133: 125-126. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
M. De Bonis, E. Lapenna, F. Sorrentino, G. La Canna, A. Grimaldi, F. Maisano, L. Torracca, and O. Alfieri
Evolution of tricuspid regurgitation after mitral valve repair for functional mitral regurgitation in dilated cardiomyopathy
Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 600 - 606.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
S. Yavuz
Should stitch annuloplasty really be abandoned for developed flexible prosthetic band or ring in functional tricuspid regurgitation?
Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 736 - 736.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Peterffy, I. Szentkiralyi, and Z. Galajda
Tricuspid valve repair: Indication and type of repair
J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 266 - 267.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2007 by The American Association for Thoracic Surgery.