A retrospective comparative analysis of trends of selected echocardiographic parameters in tricuspid valve repair with mitral valve replacement cases involving use of suture annuloplasty vs ring annuloplasty for tricuspid repair: A single-center study

Objective: Suture annuloplasty (SA) and ring annuloplasty (RA) are both used for tricuspid valve repair.Previously there have been studies comparing intra-op and post-op parameters and outcomes.Here we highlight the comparison of trends of selected echocardiographic parameters in mitral valve replacement (MVR) cases with tricuspid repair done.Methods: In this retrospective study, 70 cases who underwent MVR with tricuspid repair from 2024-25 at our institute were selected.Two groups of 35 cases each were made as per the technique of tricuspid repair used (SA and RA).Three echocardiographic parameters -left ventricular ejection fraction/right ventricular systolic pressure (LVEF/ RVSP) and tricuspid regurgitation maximal gradient (TR G max) values were documented at pre-operative / post-operative and 6 months follow up in both groups to observe the trend of changes in these parameters.Results: Baseline demographic characters were statistically comparable in both groups.Both the groups show nonsignificant results trends observed during preoperative, postoperative and follow-up period.However, RA when compared with SA showed significant improvement (p<0.0001) in LVEF, RVSP and TR G max which was observed from preoperative period to follow-up.Both SA and RA resulted in significant reduction of TR severity postoperatively (p<0.001).At follow-up, mild TR was observed in 68.6% of patients with SA and 82.9% with RA .Recurrence of moderate-to-severe TR was lower in the RA group (17.1%) compared to the SA group (31.4%).These findings suggest that RA provides more durable correction of tricuspid regurgitation than SA.Conclusion: Despite having different tricuspid valve repair techniques used, post-operative left ventricular dysfunction is inevitable but there is improvement in RVSP and TR G max.Hence, we conclude that both the annuloplasty techniques (ring and suture) can be used with RA performing better in terms of observed trends of echocardiographic parameters and in providing more durable correction of tricuspid regurgitation grades.