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DOI: 10.1055/s-0030-1269202
Midterm follow up of tricuspid valve repair without failure – a single center experience
Introduction: Valve replacement in tricuspid position have shown less than satisfactory results with high incidence of complications. In hospital mortality of up to 15% were shown in literature.
Aims: From Juli 2006 through May 2010, 38 patients underwent a tricuspid valve repair without any replacement (100%). 32 patients had a complex procedure that includes a tricuspid valve repair (84.2%). There were 17 males and 21 females. Ages ranged from 42 to 81 years. There was preoperative tricuspid valve regurgitation grad III to IV in all patients. Tricuspid valve repair was developed only with a ring annuloplasty (Carpentier Edwards classic ring) in 32 patients (84.2%), with a ring annulopasty and reconstruction of the leaflets in 4 patients (10.5%) and with ring annuloplasty and artificial chordae in 2 patients (5.3%). Concomitant procedures included coronary bypass grafting, mitral valve surgery, aortic valve surgery or ablation of atrial fibrillation.
Results: There was no in hospital death and only 2 late deaths (5.3%), both without cardiac reason (cancer and sepsis coursed of leg infection). Currently survival rate was 94.7% at a midterm follow up of 38 month. Freedom from reoperation in this time was 100%. After midterm follow up 19 patients (50%) had no measurable tricuspid regurgitation, 17 patients (44.7%) only mild regurgitation und 2 patients (5.3%) had a tricuspid valve insufficiency grad II.
Conclusion: In summarizing our own results tricuspid valve replacement is not a surgical option for patients with severe tricuspid valve regurgitation. We recommend tricuspid valve repair with annuloplasty ring and in special cases, the implantation of artificial chordae.