title: Surgery for tricuspid insufficiency: long-term follow-up after De Vega annuloplasty.
abstract: Between 1975 and 1991, 97 consecutive patients underwent De Vega tricuspid annuloplasty either isolated or in combination with mitral, aortic, or mitral and aortic valve procedures. Preoperatively 96.9% of the patients were in New York Heart Association functional class III or IV. Causes of tricuspid insufficiency were functional tricuspid ring dilatation and a combination of dilatation and different organic tricuspid valve lesions. There were 17 early deaths (17.5%), primarily due to cardiac failure, none was related to the tricuspid annuloplasty. 80 perioperative survivors have been followed up for a mean of 4.7 +/- 4.1 years with a total of 462 cumulative patient-years. Actuarial 5-, 10-, and 15-year survival rates, including early deaths, were 64% +/- 5%, 48 +/- 6%, and 26% +/- 10%. Recurrence of tricuspid regurgitation was rated as moderate in 15% and severe in 18.8%. Ten patients required reoperation (2.2%/patient-year), of whom 8 were associated with tricuspid regurgitation (1.7%/patient-year). Although in all patients but one the De Vega annuloplasty was intact, the tricuspid ring was dilated; 4 patients had additional tricuspid organic valve lesions. 6 of the 8 patients had concomitant mitral valve or mitral prosthesis dysfunction. 26 patients died late (5.6%/patient-year) due to chronic cardiac failure in 50% and after reoperation in 7% of the patients. 4 patients had implantation of a permanent pacemaker (0.9%/patient-year). 54 patients (67.5%) are still alive, with 43% having no and 17.5% having only mild residual tricuspid regurgitation. De Vega annuloplasty is indicated with tricuspid insufficiency due to functional ring dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Cardiovascular Surgery, German Heart Center Munich.
authors.forename: K
authors.initials: K
authors.lastname: Holper
authors.forename: J C
authors.initials: JC
authors.lastname: Haehnel
authors.forename: N
authors.initials: N
authors.lastname: Augustin
authors.forename: F
authors.initials: F
authors.lastname: Sebening
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D005860:Germany, West / Q000453:epidemiology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D013536:Suture Techniques; D013997:Time Factors; D014261:Tricuspid Valve / Q000503:physiopathology / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*