A three-dimensional ring annuloplasty for the treatment of tricuspid regurgitation.
OBJECTIVE
Significant functional tricuspid regurgitation should be corrected in patients undergoing surgery for left-sided valvular diseases. Several clinical studies have shown the superiority of the remodeling annuloplasty over other repair techniques. Herein we report our early experience with a new three-dimensional remodeling prosthetic ring (Edwards MC3 annuloplasty system [Edwards LifeSciences, Irvine, CA]).


METHODS
From June 2002 to November 2004, 75 patients with functional tricuspid regurgitation (mean, 3.1 +/- 0.9) underwent tricuspid valve repair with this new prosthesis. Concomitant procedures were mitral valve repair (70%), replacement (26%), aortic valve replacement (10%), coronary artery bypass grafting (13%), and left atrial maze (34%). Median predicted EuroScore mortality was 21% (r = 3 to 62).


RESULTS
Operative mortality was 5.3% (n = 4). Pre-discharge echocardiography showed significant decrease in tricuspid regurgitation to 0.3 +/- 0.4 (p < 0.001). Forty-five patients had follow-up transthoracic echocardiography after a median of 16 months (range, 4 to 34) demonstrating a stable result (mean tricuspid regurgitation, 0.3 +/- 0.5). There were no cases of ring dehiscence, prosthetic ring endocarditis, or thromboembolic events.


CONCLUSIONS
This new three-dimensional ring is easy to implant, corrects tricuspid regurgitation effectively, and provides good short-term clinical and echocardiographic results. Long-term evaluation, however, is necessary to determine the stability of tricuspid valve repair using the MC3 annuloplasty system.
Filsoufi
Farzan
F
Department of Cardiothoracic Surgery, Mount Sinai Hospital, New York, New York, USA. farzan.filsoufi@mountsinai.org
Salzberg
Sacha P
SP
Coutu
Marianne
M
Adams
David H
DH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery; D002304:Cardiac Pacing, Artificial; D015897:Comorbidity; D001026:Coronary Artery Bypass; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D009102:Multiple Organ Failure / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography