Re-Repair of Tricuspid Valve after Tricuspid Suture Annuloplasty: An Analysis of the Causes for Reoperation and its Durability

Background and aim of the study: The outcomes of re-repair of the tricuspid valve to treat recurrent tricuspid regurgitation (TR) after tricuspid valve suture surgery were analyzed.

Methods: Thirty-six patients (mean age 65.3 ± 9.3 years) who underwent re-repair of the tricuspid valve to treat recurrent TR between January 1990 and November 2014 were reviewed retrospectively. All patients underwent suture annuloplasty for TR. Of these 36 patients, 15 (41.7%) underwent ring annuloplasty and 21 (58.3%) underwent re-suture annuloplasty. The mean follow up period was 5.8 ± 6.1 years.

Results: The overall hospital mortality rate was 13.9% (5/36). Pre-discharge TR grades were 1.2 ± 0.7 in the ring

group and 1.4 ± 0.8 in the re-suture group (p = 0.7353). There were no significant differences in survival, freedom from late TR and freedom from valve-related events between the two groups. At the final follow up, TR >mild was present in four patients (36.4%) in the ring group, and in 12 patients (75%) in the re-suture group (p = 0.0447). Severe TR was present in five patients (31.3%) in the re-suture group, but none was present in the ring group (p = 0.2445).

Conclusion: In the present study cohort, the durability of re-repair of the tricuspid valve using a flexible prosthesis appeared to be superior to the durability following re-suture annuloplasty.

The Journal of Heart Valve Disease 2016;25:341-348