title: Recurrent tricuspid insufficiency: is the surgical repair technique a risk factor?
abstract: This study compares the medium-term results of De Vega, modified De Vega, and ring annuloplasty techniques for the correction of tricuspid insufficiency and investigates the risk factors for recurrent grades 3 and 4 tricuspid insufficiency after repair. In our clinic, 93 patients with functional tricuspid insufficiency underwent surgical tricuspid repair from May 2007 through October 2010. The study was retrospective, and all the data pertaining to the patients were retrieved from hospital records. Functional capacity, recurrent tricuspid insufficiency, and risk factors aggravating the insufficiency were analyzed for each patient. In the medium term (25.4 ± 10.3 mo), the rates of grades 3 and 4 tricuspid insufficiency in the De Vega, modified De Vega, and ring annuloplasty groups were 31%, 23.1%, and 6.1%, respectively. Logistic regression analysis revealed that chronic obstructive pulmonary disease, left ventricular dysfunction (ejection fraction, < 0.50), pulmonary artery pressure ≥60 mmHg, and the De Vega annuloplasty technique were risk factors for medium-term recurrent grades 3 and 4 tricuspid insufficiency. Medium-term survival was 90.6% for the De Vega group, 96.3% for the modified De Vega group, and 97.1% for the ring annuloplasty group. Ring annuloplasty provided the best relief from recurrent tricuspid insufficiency when compared with DeVega annuloplasty. Modified De Vega annuloplasty might be a suitable alternative to ring annuloplasty when rings are not available.
authors: Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, 34846 Kartal, Istanbul, Turkey. ikara7881@hotmail.com
authors: Ibrahim
authors: I
authors: Kara
authors: Cengiz
authors: C
authors: Koksal
authors: Canturk
authors: C
authors: Cakalagaoglu
authors: Muslum
authors: M
authors: Sahin
authors: Mehmet
authors: M
authors: Yanartas
authors: Yasin
authors: Y
authors: Ay
authors: Serdar
authors: S
authors: Demir
mesh_terms: D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011651:Pulmonary Artery / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: Clinical trial; regression analysis; surgery/techniques; treatment outcome; tricuspid valve insufficiency/complications/etiology/surgery; tricuspid valve/surgery