title: Effect of the septal adjustment technique for tricuspid annuloplasty with an MC3 ring.
abstract: OBJECTIVE
  Functional tricuspid regurgitation (FTR) is a significant negative prospective factor for long-term survival in patients with mitral valve disease. Tricuspid annuloplasty (TAP) for FTR is recommended as a concomitant procedure during left-sided valvular surgery. The MC3 annuloplasty ring is designed to restore the dilated tricuspid annulus to its natural three-dimensional shape, but selection of the optimal ring size during TAP is sometimes difficult. One solution is the septal adjustment technique (SAT), in which the point of fixation of the septal portion to the septal annulus is adjusted under confirmation with the water test. Here, we evaluated early outcomes with this new technique.
  
  
  METHODS
  Between January 2008 and September 2014, 56 patients (mean age 67.6 ± 9.0 years, male/female 28/28) with FTR underwent TAP with an MC3 ring. We retrospectively compared early outcomes, including mortality, morbidity and postoperative residual tricuspid regurgitation (TR), between patients undergoing TAP with the SAT (n = 19, Group A) and those undergoing TAP with the conventional technique (n = 37, Group C).
  
  
  RESULTS
  Although preoperative TR grade was significantly higher in Group A than Group C (3.2 ± 0.6 vs. 2.8 ± 0.6, p = 0.032), postoperative TR grade was significantly lower in Group A than Group C (0.9 ± 0.6 vs. 1.4 ± 0.8, p = 0.039), and TR grade was significantly decreased in Group A compared to Group C (2.2 ± 0.9 vs. 1.4 ± 0.8, p = 0.004). TR area reduction was significantly larger in Group A than in Group C (5.21 ± 2.34 vs. 2.85 ± 3.09, p = 0.006).
  
  
  CONCLUSIONS
  The SAT for TAP with an MC3 ring provided better control of postoperative TR than the conventional technique.
authors: Department of Cardiovascular Surgery, Showa University, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-0064, Japan, kawaura0919@gmail.com.
authors: Hiroyuki
authors: H
authors: Kawaura
authors: Atsushi
authors: A
authors: Aoki
authors: Tadashi
authors: T
authors: Omoto
authors: Kazuto
authors: K
authors: Maruta
authors: Hirofumi
authors: H
authors: Iizuka
mesh_terms: D000368:Aged; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000517:prevention & control / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000517:prevention & control / Q000601:surgery*