Does the Use of A Ring Provide More Stable Results In Tricuspid Annuloplasty In The Long Term?
Pedro Lima-Canadas, Luis F. Lopez-Almodovar, Alfonso Cañas, Jose A. Buendia-Miñano, Pilar Pareja-Pelaez, Marta Alvarez, Mario Baquero, Carolina Maicas-Bellido.
Complejo Hospitalario Toledo, Toledo, Spain.
OBJECTIVE:The use of suture annuloplasty for tricuspid valve instead of prosthetic ring is still controversial. The objective of the study was to analyze in long term data the fate of both procedures.
METHODS: We retrospectively reviewed the database of our institution for patients with surgery between 2003 and 2009, who had tricuspid surgery either in the setting of mitral procedures or aortic-mitral procedures. Isolated tricuspid patients were excluded. We found 99 patients in the suture annuloplasty group (A), and 40 patients in the prosthetic ring group (B). There were significant differences between groups regarding gender, cross clamp time .The echocardiograms were reviewed for this patients in the follow up, and the clinical status was checked reviewing their GP and cardiology records. Mean follow up time was 76,4 months for group A and 98,1 months for group B.
RESULTS:The procedures performed in group A involved 19 mitral repair/replacement and 21 aortic and mitral repair/replacement. In group B we found 59 isolated mitral and 36 combined aortic and mitral. We plotted the time free of grade 3+ tricuspid regurgitation vs time and performed a comparison between groups. The graph is shown in graph 1. There were significant differences regarding the presence of significant regurgitation (over grade 3) in both groups (p<0,001).
CONCLUSIONS:
Prosthetic annuloplasty provides a more stable in the long-term relief for tricuspid regurgitation, even though there is a significant progression of the disease in the long term in both cases. 
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