Tricuspid valve annuloplasty using autologous pericardial strip versus band for treatment of functional tricuspid regurgitation

Abstract

Background: Options of tricuspid annuloplasty (TAP) for treatment of functional tricuspid regurgitation (FTR) include suture, ring, and autologous pericardium. The aim of this study was to evaluate and compare outcomes of TAP using pericardial strip versus band during left-sided heart valve surgery.

Methods: This retrospective study included adult patients who had autologous pericardial annuloplasty for FTR using pericardial strip and rolled pericardial band. The primary end-point was residual TR (moderate or more) during 1-year follow-up.

Results: The study included 80 patients with mean age of 52.06±11.01 years and most of them were female (63.8%). Tricuspid annuloplasty was performed using pericardial strip (n=50) or band (n=30). During follow-up period, there were no re-operation for TR, severe TR, late complications, mortality, and degeneration or retraction of the pericardial patch. The incidence of residual TR was 7.5% postoperatively and 2.5% during follow-up with no significant differences between both techniques of annuloplasty. Pericardial strip showed higher incidence of postoperative mild TR than band. There was no significant differences in postoperative complications and NYHA class. Follow-up TR grade was significantly correlated with preoperative NYHA class, pulmonary artery systolic pressure, left ventricular ejection fraction, and tricuspid annular plane systolic excursion.

Conclusion: Autologous pericardial strip or band for moderate and severe FTR had similar and acceptable rates of residual TR (moderate or more) postoperatively and at 1-year of follow-up, but pericardial band had temporally lower frequency of postoperative mild TR. Further evaluation is recommended.