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The interest for the tricuspid valve increased significantly as well among cardiologists as among surgeons. The reason is double: on one hand, the severe tricuspid regurgitation occurring occasionally after isolated mitral valve replacement; on the other hand, development of the three-dimensional echocardiography allowing a more pronounced exploration of the tricuspid valve and right ventricle functions. Because annuloplasty remains the gold standard technique in tricuspid surgery, our aim was to evaluate the impact of our tri-dimensional complete ring in improving the short and long term outcomes of this conservative surgery.
This is a prospective study including 30 patients (Mean age was 25 years). All of them were operated on for rheumatic left sided valves disease associated with grade III functional tricuspid regurgitation. Our new tri-dimensional complete ring was used for tricuspid valve repair. The average time of implantation was five minutes. The complete structure and the modulated flexibility of this new ring, exclusively made of PTFE and well tolerated materiel as demonstrated by our experimental and histological studies, are expected to respect and restore the physiology annulus, and finally lead the septal leaflet to take part to the valvular coaptation.
There was no hospital mortality and no major complications. Mean follow-up was 12 months. No significant tricuspid regurgitation was observed either at discharge or during follow up.Furthermore, 3D echocardiography showed a good remodeling of the tricuspid annulus and a significant improvement of right ventricular function.
The tri-dimensional complete ring allows a more physiologic, cheaper and faster repair of the tricuspid valve. Furthermore, our ring made exclusively from PTFE seems to be rapidly endothelalized and more resistant to infection. Whereas short and mid term results are good and promising, longer follow up is required to confirm these trends.
- 2013 American College of Cardiology Foundation