Autologous Pericardial Band for Tricuspid Valve Annuloplasty: Midterm Results

Khaled  Mohamed Abdelaal; Mohamed Abdel-Bary; Sharaf  ED Mahmoud; Mohamed  Eid; Abdelhady  Ahmad Helmy; Ayman  Mohammad Abdelghaffar

doi:10.35810/ects.v4i2.214

Khaled Mohamed Abdelaal Department of Cardiothoracic Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt
Mohamed Abdel-Bary Department of Cardiothoracic Surgery, Faculty of Medicine, South Valley University, Qena, Egypt
Sharaf ED Mahmoud Department of Internal Medicine, Faculty of Medicine, Sohag University, Sohag, Egypt
Mohamed Eid Department of Internal Medicine, Faculty of Medicine, Sohag University, Sohag, Egypt
Abdelhady Ahmad Helmy Department of Anesthesia and Intensive Care, Faculty of Medicine, Sohag University, Sohag, Egypt
Ayman Mohammad Abdelghaffar Department of Cardiothoracic Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt

DOI: https://doi.org/10.35810/ects.v4i2.214

Keywords: Tricuspid regurgitation, Tricuspid annuloplasty, Autologous pericardial band, Suture annuloplasty

Abstract

Background: Even though tricuspid regurgitation (TR) is a frequent cardiac valve disorder, and tricuspid valve annuloplasty (TVA) has been evolved to manage TR for more than 50 years, there is still a substantial controversy regarding the best durable method for TVA. We reported our midterm (3 years) outcomes of TVA using autologous pericardial (AP) band comparing it with DeVega annuloplasty for the management of functional TR.

Methods: Between January 2017 and November 2018, about 175 cases with moderate or more TR underwent TVA as a part of primary left-sided valve replacement surgery. Autologous pericardial (AP) TVA was performed in 100 patients, and DeVega TVA in 75 patients.

Results: Both groups are comparable as regards preoperative characteristics. Immediate postoperatively, regarding NYHA class, degree of TR, ejection fraction, and pulmonary artery systolic pressure, there was a marked improvement within the 2 groups compared to the preoperative values, without a significant difference between both groups. 94% of patients completed the follow-up period. In hospital death was 2% in the AP group, and 1% in the DeVega group. The AP group showed a marked improvement in the mean degree of TR at the same follow-up period compared to the DeVega group, 12% patients of the AP group and 21% patients of the De Vega group had 3+ or 4+ TR at 3 years postoperative follow up. There was a marked improvement in the Diastolic tricuspid annuloplasty diameter in the AP group compared to the DeVega group. There were 6.3% late deaths in our study.

Conclusion: TVA with an AP was more durable than the DeVega in avoiding postoperative TR progression on the midterm results.