De Vega's annuloplasty for tricuspid regurgitation.
A total of 337 patients underwent a mitral or combined mitral and aortic valve operation at the Oulu University Hospital between 1986 and 1992. Of these, 30 (8.9%) patients had De Vega's semicircular annuloplasty performed because of tricuspid regurgitation (TR) which was considered functional in nature. There were five (16.6%) early and seven (23.3%) late deaths during the follow-up period of 10 to 71 months. The preoperative mean New York Heart Association (NYHA) functional class was 3.4, and at follow-up 13 (76.5%) of the survivors were in NYHA CLass I or II. The actuarial survival rate was 37.6% at five years. All the survivors were evaluated echocardiographically and the TR was considered mild in 56.3%, moderate in 25.0% and severe in 18.7% of the cases. Tricuspid annuloplasty using De Vega's semicircular suture technique is a simple and effective procedure in patients with mild to moderate regurgitation. In patients with massive regurgitation, which is usually associated with a massively dilated tricuspid annulus and pulmonary hypertension, annuloplasty should be reinforced using a ring technique. Tricuspid valve replacement is hardly ever needed in the treatment of functional tricuspid regurgitation.
Peltola
T
T
Department of Cardiothoracic Surgery, Oulu University Hospital, Finland.
Lepojärvi
M
M
Ikäheimo
M
M
Kärkölä
P
P
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality; D015996:Survival Rate; D013536:Suture Techniques; D014261:Tricuspid Valve / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000401:mortality / Q000601:surgery*