Key result
Combining leaflet repair with annuloplasty may improve durability over annuloplasty alone for complex TR.
Why the study?
Do tricuspid valve repair techniques combined with annuloplasty improve repair durability compared to annuloplasty alone in patients with tricuspid regurgitation?
Do tricuspid valve repair techniques combined with annuloplasty improve repair durability compared to annuloplasty alone in patients with tricuspid regurgitation?
Combining tricuspid valve repair techniques with annuloplasty may offer more durable solutions for severe tricuspid regurgitation than annuloplasty alone.
Supports adjunctive techniques in complex cases; hypothesis-generating and requires randomized confirmation before practice change.
Tricuspid regurgitation (TR) represents a significant disease process and when severe, is associated with increased mortality. Recent guidelines support a more aggressive approach to tricuspid valve (TV) surgery, especially when encountered with left-sided valvular pathology. While annuloplasty has been the standard treatment for TR, it may not provide as effective or durable a repair compared to annuloplasty combined with TV repair techniques. Several of these approaches are discussed including bicuspidalization, anterior leaflet augmentation, edge to edge repair, neochords, leaflet resection and combined approaches. Although patient cohorts in most of the studies examining these techniques are small, the long-term durability of TV repair is significant.
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Boyd et al. (2017) conducted a review in Tricuspid regurgitation. Tricuspid leaflet repair techniques was evaluated. Combining annuloplasty with tricuspid leaflet repair techniques such as bicuspidalization, leaflet augmentation, or edge-to-edge repair may provide more effective and durable results than annuloplasty alone for complex tricuspid regurgitation.
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