Hospital outcomes of surgical treatment for functional tricuspid valve insufficiency depending on the chosen method of surgical treatment

Purpose. To study and compare hospital outcomes of surgical treatment of functional (secondary) tricuspid insufficiency, depending on its etiology and on the chosen surgical method of its correction.
Materials and methods. We performed clinical and hemodynamic evaluation of the outcomes of various methods of cardiac surgical treatment of patients with non-rheumatic tricuspid valve (TV) insufficiency (functional) in chronic forms of coronary artery disease (CAD), and delated cardiomyopathy (DCM). The study included 792 patients who during a period from 2011 to 2020 underwent correction of non-rheumatic TV insufficiency (functional): There were 642 participants with CAD, 150 participants with DCM. We assessed their echocardiographic parameters.
Results. In the analyzed sample at the hospital stage, there was a significant decrease in the severity of tricuspid insufficiency after the performed TV repair. We found no influence of the etiology of TV lesion on the incidence of residual tricuspid insufficiency grade ≥ II at the hospital stage. In general, there was no effect of the TV plasty method (annuloplasty or suture techniques) on the incidence of residual tricuspid insufficiency grade ≥ II at the hospital stage. But significant differences were found depending on the specific method of annuloplasty both in patients with CAD and in patients with DCM: the maximum incidence of residual tricuspid regurgitation (TR) grade ≥ 2 was registered after soft ring annuloplasty, the minimum was after annuloplasty with soft semi-ring made of felt strips according to the original method. At the same time, after performing annuloplasty with a soft half-ring made of felt strip according to the original method in patients with DCM, no recurrence of TR grade ≥ 2 was noted in any patient. Also, in the analyzed sample, significant differences were found depending on the type of corrector ring implanted during annuloplasty: when implanting the Plankor-A corrector ring, as well as the Medtronic Contour 3D corrector ring, the frequency of residual TR grade ≥ 2 was minimal, slightly higher with the implantation of the Plankor-T corrector ring, and maximum with the implantation of the Carperntier Edwards MC3 corrector ring.
Conclusion. The etiology of TV lesions does not affect the incidence of clinically significant residual tricuspid insufficiency. In general, the groups of ring and suture plasty methods did not differ in the incidence of residual tricuspid insufficiency grade ≥ II at the hospital stage. But among all methods of annuloplasty, the lowest frequency of clinically significant residual TR was observed after annuloplasty with a soft semi-ring made of felt strip according to the original method.

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