Key result
The distance between the tricuspid valve annulus and the right coronary artery ranged from a minimum of 10 mm to a maximum of 20 mm, indicating that a stitch depth within 10 mm is safe during De Vega's annuloplasty.
Observational (n=46)
Anatomical measurements of explanted human hearts demonstrate that a stitch depth within 10 mm during De Vega's tricuspid annuloplasty is safe and will not injure the right coronary artery.
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Anatomical data support limiting suture depth in De Vega annuloplasty; leaves open in vivo confirmation before practice change.
BACKGROUND: The durability of De Vega's tricuspid valve annuloplasty might be related to tension of the annulus and could be reinforced by increasing stich depth. However, depth of stitches to date has not been addressed in the literature. Thus, it is important to better understand the anatomical distance between the tricuspid valve annulus and the right coronary artery. METHODS: From 1998 to 2009, we measured the distances between TV annulus and RCA (TRD) on 46 explanted human hearts during heart transplantation. Five points were measured from the anterior/septal leaflet commissure to the posterior/septal leaflet commissure clockwise. Statistical significance was tested in the analyses. RESULTS: We found the TRD were independent from sex, age, body weight, and etiology. With a minimum of 10 mm at the posterior/septal leaflet commissure, the distances increased counterclockwise to the maximum of 20 mm at the anterior/septal leaflet commissure. CONCLUSIONS: Stitch depth within 10 millimeter will not injure the right coronary artery in making De Vega's tricuspid annuloplasty.
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Lee et al. (2015) conducted an observational in Heart failure requiring transplantation (n=46). Anatomical measurement of tricuspid valve annulus to right coronary artery distance was evaluated on Distance between tricuspid valve annulus and right coronary artery (TRD) at five locations (p=<0.0001). The distance between the tricuspid valve annulus and the right coronary artery ranged from a minimum of 10 mm to a maximum of 20 mm, indicating that a stitch depth within 10 mm is safe during De Vega's annuloplasty.
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