[Short-term effectiveness analysis of three different tricuspid valve plasty for functional tricuspid regurgitation].

OBJECTIVE: To compare and evaluate the short-term outcomes of 3 different tricuspid valve plasty for functional tricuspid regurgitation (TR) in patients with rheumatic heart disease.

METHODS: Between October 2010 and June 2011, 148 patients with rheumatic heart disease undergoing left heart valve replacement and tricuspid valve plasty for functional TR were enrolled in the study. There were 32 males and 116 females with an average age of 47.5 years (range, 15-66 years). The patients were divided into 3 groups depending on tricuspid valve plasty: Cosgrove-Edwards annuloplasty ring group (annuloplasty ring group, 58 cases), Kay annuloplasty group (Kay group, 61 cases), and DeVega annuloplasty group (DeVaga group, 29 cases). There was no significant difference in general data among groups (P > 0.05), except more severe TR degree, higher atrial fibrillation, and higher radiofrequency ablation in annuloplasty ring group (P < 0.05). Perioperative data were recorded. The heart function was evaluated according to the standard of New York Heart Association (NYHA). Echocardiography (ECG) was used to record the TR class during perioperative period and follow-up.

RESULTS: After operation, 1 case in Kay group and 1 case in annuloplasty ring group were dead because of low cardiac output syndrome. Pneumonia happened in 2 cases of Kay group and in 1 case of annuloplasty ring group; re-operation was performed in 1 case of annuloplasty ring group because of sternal dehiscence. There was no significant difference in perioperative complication among 3 groups (P = 0.840). The TR degree was significantly improved at discharge when compared with preoperative degree in 3 groups (P < 0.001). A total of 146 patients were followed up 6-12 months (mean, 7.3 months). The NYHA grade of 3 groups at last follow-up was improved when compared with preoperative grade (P < 0.001), but no significant difference among 3 groups (chi2 = 0.120, P = 0.942). The TR degree at last follow-up was all improved in 3 groups when compared with preoperative degree (P < 0.001); the improved efficiency showed significant difference among 3 groups (chi2 = 26.827, P = 0.000), it was significantly better in annuloplasty ring group than in the other 2 groups (P < 0.001), but no significant difference between DeVega group and Kay group (Z = 1.467, P = 0.142).

CONCLUSION: The early improved efficiency of TR after Cosgrove-Edwards annuloplasty is superior to that of Kay annuloplasty and DeVega annuloplasty.