Key result
Autologous pericardial band annuloplasty links to ~43% less severe TR at 3 years versus DeVega.
Why the study?
There is substantial controversy regarding the best durable method for tricuspid valve annuloplasty to manage tricuspid regurgitation.
Does autologous pericardial band tricuspid valve annuloplasty reduce postoperative TR progression compared to DeVega annuloplasty in patients with moderate or more functional TR undergoing left-sided valve surgery?
Cohort (n=175)
Does autologous pericardial band tricuspid valve annuloplasty reduce postoperative TR progression compared to DeVega annuloplasty in patients with moderate or more functional TR undergoing left-sided valve surgery?
Absolute Event Rate: 12% vs 21%
Autologous pericardial band annuloplasty appears more durable than DeVega annuloplasty in preventing midterm tricuspid regurgitation progression.
AP pericardial band may support durable functional TR repair; leaves open randomized comparison versus DeVega.
Background: Even though tricuspid regurgitation (TR) is a frequent cardiac valve disorder, and tricuspid valve annuloplasty (TVA) has been evolved to manage TR for more than 50 years, there is still a substantial controversy regarding the best durable method for TVA. We reported our midterm (3 years) outcomes of TVA using autologous pericardial (AP) band comparing it with DeVega annuloplasty for the management of functional TR. Methods: Between January 2017 and November 2018, about 175 cases with moderate or more TR underwent TVA as a part of primary left-sided valve replacement surgery. Autologous pericardial (AP) TVA was performed in 100 patients, and DeVega TVA in 75 patients. Results: Both groups are comparable as regards preoperative characteristics. Immediate postoperatively, regarding NYHA class, degree of TR, ejection fraction, and pulmonary artery systolic pressure, there was a marked improvement within the 2 groups compared to the preoperative values, without a significant difference between both groups. 94% of patients completed the follow-up period. In hospital death was 2% in the AP group, and 1% in the DeVega group. The AP group showed a marked improvement in the mean degree of TR at the same follow-up period compared to the DeVega group, 12% patients of the AP group and 21% patients of the De Vega group had 3+ or 4+ TR at 3 years postoperative follow up. There was a marked improvement in the Diastolic tricuspid annuloplasty diameter in the AP group compared to the DeVega group. There were 6.3% late deaths in our study. Conclusion: TVA with an AP was more durable than the DeVega in avoiding postoperative TR progression on the midterm results.
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Abdelaal et al. (2022) conducted a cohort in Functional tricuspid regurgitation (n=175). Autologous pericardial band annuloplasty vs. DeVega annuloplasty was evaluated on 3+ or 4+ tricuspid regurgitation at 3 years postoperative follow up. Tricuspid valve annuloplasty with an autologous pericardial band reduced the rate of 3+ or 4+ tricuspid regurgitation at 3 years compared to DeVega annuloplasty (12% vs 21%).
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