title: Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease.
abstract: BACKGROUND
  Annuloplasty bands and rings are widely used for repairing functional tricuspid regurgitation (FTR). However, the question regarding which is the ideal annuloplasty device remains unclear. The aim of this study was to compare the efficacy and mid-term durability of tricuspid ring annuloplasty for FTR secondary to rheumatic mitral valve disease using flexible Cosgrove-Edwards band and the rigid Edwards MC3 ring (Edwards Lifesciences, LLC, Irvine, CA, USA).
  
  
  METHODS
  We retrospectively collected the clinical data of those who underwent mitral valve replacement (MVR) in concomitant with tricuspid ring annuloplasty from 2009 to 2013. The flexible band was used in 46 patients (flexible group), and the 3D rigid ring was used in 60 patients (rigid group). Echocardiographic evaluation of tricuspid function was performed preoperatively and postoperatively.
  
  
  RESULTS
  The grade of TR was significantly improved compared to preoperative values in two groups. There was no significant difference regarding postoperative TR grade between the two groups at 1 week and 2-3 months but there was statistical significant difference at postoperative 6-12 months, and 2-3 years. During the follow up period, 25 of 46 patients (54.3%) in flexible group and 22 of 60 patients (30.3%) in rigid group developed recurrent TR. Freedom from recurrent TR in flexible group is significant lower than rigid group in each postoperative follow up period.
  
  
  CONCLUSIONS
  These findings suggest that 3D rigid ring annuloplasty might be more effective for tricuspid ring annuloplasty in FTR in mid-term postoperative periods when compared to flexible band.
authors.affiliation: Department of Cardiovascular Surgery, Qingdao University, Affiliated Hospital of Qingdao University, Qingdao 266000, China;; Department of Cardiovascular Surgery, Qingdao Fuwai Cardiovascular disease Hospital, Qingdao 266034, China.
authors.forename: Haiping
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular Surgery, Qingdao Fuwai Cardiovascular disease Hospital, Qingdao 266034, China.
authors.forename: Xiancheng
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Surgery, Qingdao Fuwai Cardiovascular disease Hospital, Qingdao 266034, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular Surgery, Qingdao Fuwai Cardiovascular disease Hospital, Qingdao 266034, China.
authors.forename: Zhenqian
authors.initials: Z
authors.lastname: Lv
authors.affiliation: Department of Cardiovascular Surgery, Qingdao Fuwai Cardiovascular disease Hospital, Qingdao 266034, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Surgery, Qingdao University, Affiliated Hospital of Qingdao University, Qingdao 266000, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Xu
keywords: Tricuspid regurgitation (TR); ring annuloplasty; tricuspid valve repair