Faculty Collaboration Database

Outcomes of ring versus suture annuloplasty for tricuspid valve repair in patients undergoing mitral valve surgery. J Thorac Cardiovasc Surg 2016 Aug;152(2):406-415.e3

Date

06/05/2016

Pubmed ID

27260957

DOI

10.1016/j.jtcvs.2016.04.068

Scopus ID

2-s2.0-84973920696 (requires institutional sign-in at Scopus site)   40 Citations

Abstract

OBJECTIVE: There is controversy regarding the comparative effectiveness of methods of tricuspid valve (TV) repair-prosthetic ring versus suture annuloplasty-in patients undergoing operation for primary mitral valve (MV) disease. In this study, we analyzed factors associated with patient survival and recurrent tricuspid regurgitation (TR) following TV repair and focused on results stratified by method of tricuspid valve repair.

METHODS: We reviewed patients who underwent TV repair with suture (De Vega) or flexible ring annuloplasties at the time of MV surgery from 1995 to 2010. Patients with prior cardiac or concomitant aortic valve operations were excluded. Propensity matching was performed to account for potential differences in baseline characteristics between the groups. Primary outcomes were long-term mortality and postoperative TR grade.

RESULTS: In the overall study, there were 415 patients with median age 72 years (range, 63-78 years), from which 148 matched pairs were identified by propensity score analysis. In the overall cohort, patients in the ring annuloplasty group more often had preoperative transvenous pacemakers (P = .05), lower ejection fractions (P = .028), and more recent years of operation (P < .001). For patients who had De Vega suture annuloplasty, long-term mortality was not different from that of patients who had ring annuloplasty (hazard ratio, 0.93; 95% confidence interval, 0.67-1.30). Older age, preoperative diabetes, and preoperative right ventricular dysfunction were predictors for long-term mortality. Durability of the annuloplasty methods was similar with no significant difference in trend of recurrent TR grades over follow-up (P = .807). Etiology of mitral regurgitation was not associated with recurrent TR during follow-up (P = .857).

CONCLUSIONS: Late survival and TV durability following concomitant TV repair during MV surgery did not differ with respect to TV repair technique. In this series of patients with repaired tricuspid valves, etiology of MV disease did not influence postoperative changes in TR.

Author List

Shinn SH, Dayan V, Schaff HV, Dearani JA, Joyce LD, Lahr B, Greason KL, Stulak JM, Daly RC

MESH terms used to index this publication - Major topics in bold

Aged
Chi-Square Distribution
Comparative Effectiveness Research
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mitral Valve
Mitral Valve Annuloplasty
Mitral Valve Insufficiency
Propensity Score
Proportional Hazards Models
Prosthesis Design
Recovery of Function
Recurrence
Retrospective Studies
Risk Factors
Suture Techniques
Time Factors
Treatment Outcome
Tricuspid Valve
Tricuspid Valve Insufficiency