Tricuspid annuloplasty using De Vega modified technique – Short-term and medium-term results

BackgroundTricuspid regurgitation is very often present in patients undergoing combined cardiosurgery operation. Tricuspid annuloplasty using modified De Vega technique is one of the possible approaches during the operation.AimTo evaluate short-term and medium-term results of tricuspid valve annuloplasty by De Vega modified technique.Methods and resultsFrom 1 April 2000 to 31 December 2013, there were total of 529 tricuspid valve repairs performed, out of which 43 patients had De Vega modified annuloplasty, in the Cardiocentre of České Budějovice Hospital, Inc. The cohort is composed of 17 males and 26 females with mean age (±SD) 69 ± 7 years (range 45–83 years).The tricuspid annuloplasty was performed using modified De Vega technique.The results were evaluated by transoesophageal echocardiography (TEE) postoperatively and by transthoracal echocardiography (TTE) prior to discharge, and then afterwards once a year by TTE and clinical examination.In the cohort we have followed-up the degree of tricuspid regurgitation, left ventricle ejection fraction (LVEF), heart rhythm, NYHA functional class, need for reoperation, and mortality.Tricuspid valve repair has always been a part of combined procedure, including 3 patients who were reoperated.In the early post-operative period (30-day mortality), 5 patients died (11.6%), and there were total of 8 patients who died within one year after surgery (18.6%).The mean time of follow-up was 4 years and 7 months.ConclusionTricuspid annuloplasty using modified De Vega technique to treat secondary tricuspid regurgitation appears to be a reliable technique of valvular repair in short-term and medium-term follow-up, especially in cases where valve insufficiency and degree of valvular annulus dilatation are of borderline significance. During the follow-up period we have not noted any case of purse-suture-related tissue tearing after the modified surgery as it has been reported in the classic procedure.