Novel three-dimensional semi-rigid ring annuloplasty for concomitant tricuspid valve regurgitation

Objective: Several two and three-dimensional tricuspid valve annuloplasty rings have been used to deal with functional tricuspid valve regurgitation. However, residual or recurrent valve regurgitation occurs in 20% to 30% of patients. Here we report on the first experience with a new 3-dimensional semi-rigid annuloplasty ring. Methods: From January 2018 and December 2021, 20 patients underwent tricuspid valve annuloplasty for functional tricuspid valve regurgitation using a new 3-dimensional semi-rigid Star annuloplasty ring (manufactured by LABCOR®). Eighteen patients had associated mitral valve replacement; one had aortic and mitral valves replacement; and one a mitral valve repair. The tow year’s follow-up rate was 100% (cumulative total 20 patient-years). Results: Reduction of left atrium diameter (57.7 ± 8.4mm preoperatively to 51.1 ± 8.7mm post-operatively), reduction of tricuspid annulus (42 ± 16.3mm preoperatively to 26 ± 3.8mm postoperatively), reduction of tricuspid valve regurgitation, and a significant improvement of functional capacity on a clinical evaluation from an average of class 2.75 ± 0.7 preoperatively to class 1.2 ± 0.6 at the end of follow-up. Conclusions: This novel 3-dimensional semi-rigid Star annuloplasty Ring® is safe, with no patient experiencing atrioventricular disjunction or needed pacemaker implant, and it is effective especially in patients with severely dilated tricuspid annulus and right ventricular dysfunction.