A three-dimensional ring annuloplasty for the treatment of tricuspid regurgitation.

Abstract

PURPOSE:

Significant functional tricuspid regurgitation should be corrected in patients undergoing surgery for left-sided valvular diseases. Several clinical studies have shown the superiority of the remodeling annuloplasty over other repair techniques. Herein we report our early experience with a new three-dimensional remodeling prosthetic ring (Edwards MC3 annuloplasty system [Edwards LifeSciences, Irvine, CA]).

DESCRIPTION:

From June 2002 to November 2004, 75 patients with functional tricuspid regurgitation (mean, 3.1 +/- 0.9) underwent tricuspid valve repair with this new prosthesis. Concomitant procedures were mitral valve repair (70%), replacement (26%), aortic valve replacement (10%), coronary artery bypass grafting (13%), and left atrial maze (34%). Median predicted EuroScore mortality was 21% (r = 3 to 62).

EVALUATION:

Operative mortality was 5.3% (n = 4). Pre-discharge echocardiography showed significant decrease in tricuspid regurgitation to 0.3 +/- 0.4 (p < 0.001). Forty-five patients had follow-up transthoracic echocardiography after a median of 16 months (range, 4 to 34) demonstrating a stable result (mean tricuspid regurgitation, 0.3 +/- 0.5). There were no cases of ring dehiscence, prosthetic ring endocarditis, or thromboembolic events.

CONCLUSIONS:

This new three-dimensional ring is easy to implant, corrects tricuspid regurgitation effectively, and provides good short-term clinical and echocardiographic results. Long-term evaluation, however, is necessary to determine the stability of tricuspid valve repair using the MC3 annuloplasty system.

• Authors: Farzan Filsoufi, Sacha P Salzberg, Marianne Coutu, David H Adams
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 81 Issue 6 Pg. 2273-7 (Jun 2006) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 16731167 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Aortic Valve (surgery)
• Atrial Fibrillation (complications, surgery)
• Cardiac Pacing, Artificial
• Comorbidity
• Coronary Artery Bypass
• Equipment Design
• Female
• Follow-Up Studies
• Heart Valve Prosthesis Implantation
• Hospital Mortality
• Humans
• Male
• Middle Aged
• Mitral Valve (surgery)
• Multiple Organ Failure (mortality)
• Postoperative Complications (mortality)
• Prostheses and Implants
• Prosthesis Implantation (methods, mortality)
• Retrospective Studies
• Severity of Illness Index
• Treatment Outcome
• Tricuspid Valve Insufficiency (complications, diagnostic imaging, surgery)
• Ultrasonography