De Vega annuloplasty and Carpentier-Edwards ring annuloplasty for secondary tricuspid regurgitation.
OBJECTIVE
Residual or recurrent tricuspid regurgitation (TR) has been reported after several types of surgical repair. The development of late TR is an important complication of left heart surgery. The results of De Vega annuloplasty were compared with those obtained after Carpentier-Edwards ring (CE ring) annuloplasty in patients with secondary TR.


METHODS
The records of 45 patients who underwent surgery for secondary TR between January 1995 and July 2000 were reviewed retrospectively. Twenty-eight patients underwent De Vega annuloplasty, and 17 had a CE ring annuloplasty. The groups were similar with respect to associated cardiac lesions. No significant preoperative differences were observed in NYHA functional class, TR grade, and pulmonary artery pressure between the two groups.


RESULTS
One CE patient died of left ventricular dysfunction after postoperative bleeding. The 28 De Vega patients and remaining 16 CE patients had an uneventful recovery, and were discharged. Tricuspid ring size after repair was similar between groups. Mean (+/- SD) follow up in the entire patient cohort was 39+/-23 months (range: 6 to 75 months). TR recurrence was rated as grade II or III in 13 patients (45%) after De Vega annuloplasty, but was grade II or III in only one patient (6%) patient after CE ring annuloplasty. There was a significant difference in TR recurrence between the groups (p = 0.027), but no significant difference in NYHA class.


CONCLUSIONS
CE ring annuloplasty significantly decreased the recurrence of TR; thus, CE ring annuloplasty is superior to De Vega annuloplasty in patients with secondary TR.
Matsuyama
K
K
Department of Cardiovascular Surgery, Tenri Hospital, Nara, Japan.
Matsumoto
M
M
Sugita
T
T
Nishizawa
J
J
Tokuda
Y
Y
Matsuo
T
T
Ueda
Y
Y
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*