title: Late outcome of tricuspid annuloplasty using a flexible band/ring for functional tricuspid regurgitation.
abstract: BACKGROUND
  We assessed late outcome after tricuspid annuloplasty (TAP) using a flexible band or ring for functional tricuspid regurgitation (FTR).
  
  
  RESULTS
  We reviewed 220 consecutive patients (mean age, 65.4±11.4 years) who underwent TAP for FTR during mitral valve surgery between January 2000 and December 2010. Indications for TAP included the following: (1) TR grade greater than mild; (2) history of right heart failure; (3) atrial fibrillation; and (4) systolic pulmonary artery pressure (SPAP) ≥50 mmHg. The mean follow-up period was 4.4±2.6 years. Overall hospital mortality was 5.5% (12/220). The 5- and 10-year survival rates were 90.2±2.1% and 82.4±5.6%, respectively. Freedom from recurrent TR at 8 years was 78.0±6.6%. Twenty patients had a greater than mild TR grade at final follow-up. Elevated SPAP was a predictor of recurrent TR (hazard ratio, 1.091; P=0.0003), which was associated with advanced age, atrial fibrillation, rheumatic etiology and preoperative TR grade. There was a significant difference in freedom from valve-related events between residual TR greater than mild and less than moderate (log-rank test, P=0.0464). Factors affecting residual TR were preoperative TR grade (OR, 7.368; P=0.0267) and mitral valve replacement (OR, 4.369; P=0.0402).
  
  
  CONCLUSIONS
  Late outcome of TAP in the present series was acceptable. Late outcome can be improved by performing TAP before deterioration of TR.
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital.
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukunaga
authors.forename: Yukikatsu
authors.initials: Y
authors.lastname: Okada
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Konishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Murashita
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Koyama
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology; D058385:Cardiac Valve Annuloplasty / Q000295:instrumentation*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000453:epidemiology / Q000601:surgery; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D019736:Prostheses and Implants; D012008:Recurrence; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography