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Echocardiographic follow-up of tricuspid annuloplasty with a new three-dimensional ring in patients with functional tricuspid regurgitation.

Fukuda S, Gillinov AM, McCarthy PM, Matsumura Y, Thomas JD, Shiota T

Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

BACKGROUND: A new tricuspid valve (TV) annuloplasty system, the MC3 ring, includes a three-dimensional structure designed to remodel the TV annulus and preserve physiologic annular function. PURPOSE: We investigated the early- and mid-term outcomes of TV annuloplasty with the MC3 ring. METHODS: A total of 136 patients with functional tricuspid regurgitation (TR) had two-dimensional echocardiography before and 5 +/- 5 days after TV annuloplasty with the MC3 ring. Twenty-eight patients were followed for more than 1 year after surgery. Echocardiography was used to assess response to surgical therapy, including measures of cardiac function and geometry and identification of factors predisposing one to recurrent TR. RESULTS: TR severity was improved early after surgery (P < .001). At 5 days after surgery, 16% had TR graded greater than moderate; among patients followed more than 1 year, this figure was 14%. Postoperative TR severity was associated with preoperative TR severity and tethering height. CONCLUSION: TV annuloplasty with the new physiologic MC3 ring is effective for the management of TR and may be superior to conventional techniques. However, patients with extensive leaflet tethering (>1.0 cm) require additional maneuvers to ensure valve competence.

Published 6 November 2007 in J Am Soc Echocardiogr, 20(11): 1236-42.
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