Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes

Circulation. 2006 Jul 4;114(1 Suppl):I577-81. doi: 10.1161/CIRCULATIONAHA.105.001263.


Background: The purpose of this study was to compare the long-term results of tricuspid valve (TV) repair with or without an annuloplasty ring.

Methods and results: 702 patients underwent TV repair at our institution (1978 to 2003), of which 493 had, predominantly, a De Vega procedure (no ring) and 209 had an annuloplasty ring (ring). TV pathology was functional (secondary) in 74% of patients. Concomitant procedures consisted of mitral valve surgery in 80% of patients, aortic valve surgery in 33%, and coronary bypass in 14%. Clinical and echocardiographic follow-up data were obtained. Follow-up was 99% complete and was 5.9+/-4.9 (mean+/-SD) years long. Ring patients were younger (55+/-14 versus 59+/-14 years; P=0.001) and less likely to have coronary artery disease (10% versus 17%; P=0.02), more likely to be female (75% versus 65%; P=0.01) and having had previous cardiac surgery (56% versus 42%; P=0.001). Operative times were similar between the 2 groups. Long-term survival, event-free survival and freedom from recurrent TR were significantly better in the ring group, and there was a trend toward fewer TV reoperations. Multivariable analysis demonstrated that the use of an annuloplasty ring was an independent predictor of long-term survival (hazard ratio [HR], 0.7; 95% confidence interval [CI], 0.5 to 1.0; P=0.03) and event-free survival (HR, 0.8; CI, 0.6 to 1.0; P=0.04).

Conclusions: Placement of an annuloplasty ring in patients undergoing tricuspid valve repair is associated with improved survival and event-free survival.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aortic Valve / surgery
  • Coronary Artery Bypass
  • Coronary Disease / complications
  • Coronary Disease / surgery
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Heart Diseases / mortality
  • Heart Valve Diseases / complications
  • Heart Valve Diseases / mortality
  • Heart Valve Diseases / surgery
  • Humans
  • Intraoperative Period
  • Life Tables
  • Male
  • Middle Aged
  • Mitral Valve / surgery
  • Prostheses and Implants*
  • Sex Factors
  • Survival Analysis
  • Suture Techniques*
  • Treatment Outcome
  • Tricuspid Valve / diagnostic imaging
  • Tricuspid Valve / surgery*
  • Tricuspid Valve Insufficiency / epidemiology
  • Tricuspid Valve Insufficiency / surgery
  • Ultrasonography