Tricuspid Ring Annuloplasty for Functional Tricuspid Regurgitation

2016 ◽  
pp. 181-190
Author(s):  
K. M. John Chan
Keyword(s):  
Tricuspid Regurgitation ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty

Abstract 16979: Hemodynamic Comparison of Tricuspid Ring Annuloplasty vs. Hetzer Annuloplasty Technique to Repair Functional Tricuspid Regurgitation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alan Amedi ◽  
Daisuke Onohara ◽  
Muralidhar Padala
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Ex Vivo ◽  
Working Fluid ◽  
Posterior Leaflet ◽  
Anterior Leaflet ◽  
Ex Vivo Model ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty ◽  
Valve Function

Introduction: Surgical repair of functional tricuspid regurgitation (FTR) is increasingly performed, and the techniques are evolving. Annuloplasty is currently the technique of choice, with different techniques yielding varied results, and thus require optimization. Objective: In this study, we sought to compare tricuspid valve function and kinematics after ring annuloplasty and Hetzer’s double orifice repair in an ex vivo model of FTR. Methods: Ten pig hearts were mounted into a right heart simulator, and studied at 70 bpm while maintaining the total volume of working fluid. FTR was created by increasing afterload, which caused acute right ventricular dilation and TV tethering. Tricuspid valve annuloplasty (TVA) was performed with a 26mm MC 3 ring. Hetzer procedure was performed with pledgeted sutures that approximated the anteroposterior and septal annular segments. Flow probes were used to measure FTR, and leaflet kinematics with echocardiography. Results: FTR of 17.7±9.2mL(p<0.0001) after RV dilation. Repair with TVA and Hetzer reduced FTR to 8.8±6.8ml(p=0.7142) and 7.8±6.9ml(p=0.0919), respectively, but did not eliminate it. Septal leaflet excursion angle decreased by 48.1% with FTR (p=0.04 vs. baseline ) . Repair with TVA and Hetzer increased the angle to 17.3±6.7°(p=0.0312) and 21.5±8.3°(vs FTR, p=0.0034), respectively. The Hetzer improved septal leaflet mobility better than TVA (p=0.0145). The posterior leaflet excursion angle decreased by 49.2% compared to baseline to 18.4±10.5° (p=0.0060) and both TVA and Hetzer significantly improved mobility to 33.6±8.4° (p=0.0081) and 31.6±15.6° (p=0.0256), respectively. Anterior leaflet mobility decreased after FTR by 60.7% to 18.1±8.2°. The effect of these repairs on the sub-valvular apparatus was negligible. Conclusion: TVA and Hetzer both reduced regurgitation but did not eliminate it. Septal and posterior leaflet mobility was improved, while the anterior leaflet remained tethered.

Impact of tricuspid ring annuloplasty on functional tricuspid regurgitation after mitral valve surgery

2019 ◽  
Vol 32 (2) ◽  
pp. 587
Author(s):  
HeshamH Ahmed ◽  
AhmedL Dokhan ◽  
MohammedE Abdelraof ◽  
AmrM Allama ◽  
ShahzadG Raja
Keyword(s):  
Mitral Valve ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty

scholarly journals Pericardial Strip versus Ring Annuloplasty for Repair of Functional Tricuspid Regurgitation

2014 ◽  
Vol 04 (12) ◽  
pp. 239-244
Author(s):  
Husain Hamza Jabbad ◽  
Ahmed Abdelrahman Elassal ◽  
Osama Saber Eldib
Keyword(s):  
Tricuspid Regurgitation ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty

scholarly journals Functional Tricuspid Regurgitation and Ring Annuloplasty Repair

2018 ◽  
Vol 2 (4) ◽  
pp. 451-457
Author(s):  
William B. Weir ◽  
Matthew A. Romano ◽  
Steven F. Bolling
Keyword(s):  
Tricuspid Regurgitation ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty

scholarly journals The best approach for functional tricuspid regurgitation. A network meta-analysis.

2020 ◽  
Author(s):  
Michele Di Mauro ◽  
Roberto Lorusso ◽  
Alessandro Parolari ◽  
Justine Ravaux ◽  
Giorgia Bonalumi ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Gold Standard ◽  
Meta Analysis ◽  
Early Mortality ◽  
Valve Surgery ◽  
Surgical Approaches ◽  
Late Mortality ◽  
Tricuspid Annuloplasty ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty

OBJECTIVE. For many years, functional tricuspid regurgitation (FTR) was considered negligible after treatment of left-sided heart valve surgery. The aim of the present network meta-analysis is to summarize the results of four approaches in order to establish the possible gold standard. METHODS A systematic search was performed to identify all publications reporting the outcomes of four approach for FTR, not tricuspid annuloplasty (no TA), suture annuloplasty (SA), flexible (FRA), rigid rings (RRA). All studies reporting at least one the four endpoints (early and late mortality, early and late moderate or more TFR) were included in a Bayesian network meta-analysis. RESULTS There were 31 included studies with 9,663 patients. Aggregate early mortality was 5.3% no TA, 7.2% SA, 6.6% FRA and 6.4% RRA; Early TR moderate-or-more was 9.6%, 4.8%, 4.6% and 3.8%; Late mortality was 22.5%, 18.2%, 11.9% and 11.9%; Late TR moderate-or-more was 27.9%, 18.3%, 14.3% and 6.4%. Rigid or semirigid ring annuloplasty was the most effective approach for decreasing the risk of late moderate or more FTR (–85% vs. no TA; –64% vs. SA; –32% vs. FRA). Concerning late mortality, no significant differences were found among different surgical approaches, however, flexible or rigid rings reduced significantly the risk of late mortality (78% and 47%, respectively) compared with not performing TA mortality. No differences were found for early outcomes. CONCLUSIONS. Ring annuloplasty seems to offer better late outcomes compare to either suture annuloplasty or not performing TA. In particular rigid or semirigid rings provides more stable FTR across time.

Echocardiographic Predictors of Tricuspid Ring Annuloplasty Repair Failure for Functional Tricuspid Regurgitation

2019 ◽  
Vol 33 (10) ◽  
pp. 2624-2633 ◽  
Author(s):  
Andrew Maslow ◽  
Saddam Abisse ◽  
Leslie Parikh ◽  
Patricia Apruzzese ◽  
Lindsey Cilia ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty
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