title: Tricuspid valve annuloplasty using a partial flexible ring: mid-term follow-up.
abstract: BACKGROUND
  Tricuspid valve annuloplasty (TVA) using a complete or partial rigid or flexible ring is becoming common practice in the surgical treatment of tricuspid insufficiency (TI). This study evaluates the immediate outcome and the mid-term clinical and echocardiographic follow-up after TVA performed using the Cosgrove-Edwards partial flexible ring.
  
  
  METHODS
  From June 1998 to March 2002, 35 consecutive adult patients with TI > 2+ underwent TVA using this annuloplasty ring. TI was secondary to right ventricular dilation and/or dysfunction (functional TI) in 32 (91.4%) patients, and due to anatomic anomalies of the tricuspid valve (organic TI) in 3 (8.6%). Pulmonary hypertension was present in 34.4% of the patients with functional TI. Thirty-two (91.4%) patients were in preoperative NYHA functional class III or IV. The mean follow-up was 28.3 +/- 14.6 months.
  
  
  RESULTS
  There were three (8.6%) in-hospital non-valve-related cardiac deaths, and one (3.1%) non-cardiac death during follow-up. The 3-year actuarial survival was 96.5%. TI was well controlled within grade 1+ in 30 (96.8%) survivors, but one presented residual grade 2+ TI. The NYHA functional class improved to 1.3 +/- 0.5 (p = 0.035).
  
  
  CONCLUSIONS
  TVA performed using the Cosgrove-Edwards ring is a valid option for the surgical treatment of both functional and organic TI, even in case of pulmonary hypertension and at mid-term follow-up.
authors.affiliation: Department of Cardiac Surgery, Villa Torri Hospital, Bologna, Italy. giusep.gatti@tiscali.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gatti
authors.forename: Pasqua
authors.initials: P
authors.lastname: Pacilli
authors.forename: Peppino
authors.initials: P
authors.lastname: Pugliese
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D017052:Hospital Mortality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality