Key result
De Vega annuloplasty preserves tricuspid competence in ~65% of patients undergoing MVR.
Why the study?
Whether uncorrected moderate functional tricuspid regurgitation progresses in the near term or affects right ventricular size and function in patients undergoing mitral valve replacement for rheumatic mitral disease was examined against De Vega annuloplasty.
RCT (n=40)
Randomized
Answers are grounded in this paper and cite their sources.
Supports routine De Vega annuloplasty during rheumatic MVR for moderate functional TR; extends RCT evidence for preventing early TR progression and RV deterioration.
Background: In this study, we examine the outcomes of tricuspid valve repair against non-repair to see if there is a near-term progression of non-corrected moderate functional TR in patients who had mitral valve replacement for rheumatic mitral disease and if RV size and function were affected. Objectives: To evaluate the effect of the De Vega annuloplasty for repair of moderate functional TV regurge during the left heart valve surgery in early post-operative period. Patients and methods:A prospective randomized controlled trial will contain (forty patients aged from 25 to 55 years of both sexes )they will be divided into two groups of patients: Group A: Twenty patients with moderate functional tricuspid regurgitation who received tricuspid valve annuloplasty (TVA) in the form of De vega repair along with mitral valve replacement. Group B: Twenty patients with moderate functional tricuspid regurgitation who received mitral valve replacement without tricuspid valve annuloplasty (TVA). Results: TR and right ventricle diameter were found to be significantly reduced in Group A. In group B, (6) individuals (30%) had developed grade IV/IV TR after 6 months, while 65% of patients developed competent tricuspid valve after 6 months in group A .Furthermore, in group B, TABSE (tricuspid annular systemic excursion) had dropped significantly to 1.7±0.2 cm. Conclusion: In the early postoperative period, tricuspid suture annuloplasty combined with MVR can prevent the advancement of tricuspid regurgitation, right ventricular dilatation, and systolic dysfunction.
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Bakr et al. (2019) conducted an RCT in Moderate functional tricuspid regurgitation in rheumatic mitral valve disease (n=40). De Vega tricuspid valve suture annuloplasty with mitral valve replacement vs. Mitral valve replacement alone without tricuspid valve annuloplasty was evaluated on Progression of tricuspid regurgitation and right ventricular size and function at 6 months. De Vega suture annuloplasty during MVR achieved a competent tricuspid valve in 65% of patients at 6 months, whereas 30% without repair progressed to grade IV/IV TR.
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