Short-term Outcomes of Suture versus Ring Annuloplasty for Functional Tricuspid Regurgitation Concomitant with Mitral Valve Repair in Central Chest Institute of Thailand (CCIT)

Thanit Kunanusont, Sahaporn Wathanawanichakun, Chakkraphun Jampates, Piyawat Lerdsomboon, Pramote Porapakkham, Chaiwut Yottasurodom, Choosak Kasemsarn, Taweesak Chotivatanapong

Central Chest Institute of Thailand, Nonthaburi, Thailand

Date, time and location: 2018.05.25 10:30, Exhibition area, 1st Floor. Zone – D

Abstract

Objective:To compare short-term outcomes between suture and ring annuloplasty for correcting functional tricuspid regurgitation in patients underwent mitral valve repair.

Methods:A retrospective review of 134 patients underwent tricuspid annuloplasty – concomitant with mitral valve repair (MVr) from 2011 to 2015. Suture and Ring annuloplasty were performed in 46 patients (Bicuspidization; 97.8%) and 88 patients, respectively. Post-operative echocardiographic moderate or greater TR was compared between groups. Subgroup analyses were assessed regarding pre-operative mild TR and more than mild TR, MV pathology and results of mitral valve repair – Good, Fair and Bad results.

Results:There were no significant differences in patient characteristics and intraoperative data except pre-operative AF that was higher in ring group (p<0.001) and AOX time that was higher in suture group (p=0.012). Pre-operative echocardiographic values were significantly worse in ring group including LVEF (60.2±12 vs.65.6±7.4%; p=0.002), LVEDD (56.8±11.8 vs.51.6±7.9mm; p=0.003) and RVDd (23.1±7.7 vs.17.3±8.1mm; p=0.002). Mean follow-up time was 182 days (p=0.88). Post-operative moderate or greater TR was higher in suture group (overall and preoperative more than mild TR group) but no statistically significant difference (15.2% vs.9.1%; p=0.289, 27.3% vs.12.5%; p=0.174, respectively). Post-operative moderate or greater TR in ring group was significantly lower than suture group in degenerative MVr (N=62, 0% vs. 16.7%; p=0.022). There were no significant differences of moderate or greater TR between groups in Good MVr results (N=49, 15.8 vs.3.3%; p=0.285). But, there was an increasing trend of moderate or greater TR toward Fair and Bad MVr results (N=76 and N=9, respectively) in both groups (12% vs.9.8%; p=1.00, 50% vs.28.6%; p=1.00, respectively).

Conclusions:Ring annuloplasty for correcting functional tricuspid regurgitation seems to be better for controlling on post-operative moderate or greater TR than suture annuloplasty in MVr patients but have a better control of post-operative TR for degenerative MVr patients in short-term follow-up.