SShort-Term Results Of Annuloplasty Techniques In Secondary Tricuspid Regurgitation

Yıl 2025, Cilt: 12 Sayı: 1, 143 - 148, 26.03.2025

Ahmet Dolapoglu , Emin Barbarus

https://doi.org/10.34087/cbusbed.1618301

Öz

Objective: Patients with Secondary Tricuspid Regurgitation (TR) scheduled for left-sided surgery were generally followed conservatively in previous periods, but tricuspid intervention has recently become increasingly common. In this study, we aimed to report the short-term results of tricuspid repair procedures performed in our tertiary university clinic.
Materials and Methods: Data of 62 patients who underwent surgery for secondary TR at Balıkesir University Faculty of Medicine Hospital between August 2018 and May 2023 were retrospectively analyzed. Tricuspid repair procedures performed in patients with moderate to severe TR and tricuspid annulus diameter >40 mm who were scheduled for left-sided cardiac surgery were included in the study. Patients operated for primary TR, patients with active endocarditis, patients under 18 years of age, and patients with pregnancy status were excluded.
Results: The mean age of the patients included in the study was 63.74 ± 10.2 years, 46 were female (74.2%) and 16 were male (25.8%). 48 patients underwent Tricuspid Ring Annuloplasty (TRA) and 14 patients underwent De Vega suture annuloplasty procedures. Preoperative creatinine value was higher in the De-Vega group (p=0.037). In the intervention according to TR calcification, 87.5% of the patients in the TRA group had severe TR, while this rate was 50% in the De-Vega group and a significant difference was found. (p=0.004) 30-day mortality was 12.9% in total and 10.4% in the Ring annuloplasty group and 21.4% in the De-Vega suture annuloplasty group, but there was no statistically significant difference (p=0.365).
Conclusion: In this study, we planned to report the sort-term results of two repair methods of De-Vega and TRA for secondary TR.
Key Words: Tricuspid Regurgitation, Ring annuloplasty, Suture annuloplasty

Anahtar Kelimeler

tricuspid regurgitation, ring annuloplasty, suture annuloplasty

Sekonder Triküspid Yetmezliğinde Anüloplasti Tekniklerinin Erken Dönem Sonuçları

Öz

Amaç: Sekonder Triküspid Yetmezlik(TY) sol taraflı cerrahi planlanan hastalarda önceki dönemlerde genellikle konservatif takip edilmiş olup kliniğimizde gerçekleştirilen Triküspid tamir prosedürlerinin erken dönem sonuçlarını paylaşmayı amaçladık.
Yöntem ve Gereçler: 2018 Ocak-2023 Mayıs arası Balıkesir Üniversitesi Tıp Fakültesi Hastanesinde sekonder TY nedeniyle opere edilen 62 hastanın verileri retrospektif olarak incelendi. Sol taraflı kalp cerrahisi planlanan ve orta-ileri TY mevcut olan hastalarla Triküspid anülüs çapı >40 mm olan hastalara yapılan tirküspid tamir prosedürleri çalışmaya alındı. .46 hastaya Triküspid Ring anüloplasti (TRA) , 16 hastaya De Vega sütür anüloplasti prosedürleri uygulandı Primer TY nedeniyle opere edilen hastalar,aktif endokardit bulunanlar,18 yaş altı olan hastalar ve gebelik durumu olan hastalar çalışmaya dahil edilmedi.
Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 63.74 ± 10.2 , 46'sı kadın (%74.2) ve 16'sı erkek (%25.8) idi. 46 hastaya Triküspit Ring Anüloplasti (TRA) ve 16 hastaya De Vega-sütür anüloplasti prosedürleri uygulandı. Ameliyat öncesi kreatinin değeri De-Vega grubunda daha yüksekti (p=0.037). TY evrelemesine göre yapılan girişimde TRA grubundaki hastaların %87,5'inde ciddi TY varken, De-Vega grubunda bu oran %50 idi ve anlamlı fark bulundu. (p=0.004) 30 günlük mortalite toplamda %12.9 iken Ring anüloplasti grubunda %10.4, De-Vega sütür anüloplasti grubunda %21.4 idi ancak istatistiksel olarak anlamlı fark yoktu (p=0.365).
Sonuç Bu çalışmada sekonder triküspid yetmezlikte De-Vega ve TRA onarım yöntemlerinin erken dönem sonuçlarını sunmayı planladık.
Anahtar Kelimeler: Triküspit Yetmezlik, Ring anüloplasti, Sütür anüloplasti

Anahtar Kelimeler

triküspid yetmezlik, ring anüloplasti, sütür anüloplasti

Kaynakça

• 1. Hahn RT, Lawlor MK, Davidson CJ, Badhwar V, Sannino A, Spitzer E, et al. Tricuspid Valve Academic Research Consortium Definitions for Tricuspid Regurgitation and Trial Endpoints. Eur Heart J. 2023;44(43):4508-4532. doi: 10.1093/eurheartj/ehad653.
• 2. Condello F, Gitto M, Stefanini GG. Etiology, epidemiology, pathophysiology and management of tricuspid regurgitation: an overview. Rev Cardiovasc Med. 2021;22(4):1115-1142. doi:10.31083/j.rcm2204122
• 3. Hung J. The pathogenesis of functional tricuspid regurgitation. Semin Thorac Cardiovasc Surg. 2010;22(1):76-78. doi:10.1053/j.semtcvs.2010.05.004
• 4. Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. ESC/EACTS Scientific Document Group (2022). 2021 ESC/EACTS Guidelines for the management of valvular heart disease. European heart journal, 2022;43(7), 561–632. Doi:10.1093/eurheartj/ehab395
• 5. Pagnesi M, Montalto C, Mangieri A, Agricola E, Puri R, Chiarito M, et al. Tricuspid annuloplasty versus a conservative approach in patients with functional tricuspid regurgitation undergoing left-sided heart valve surgery: A study-level meta-analysis. Int J Cardiol. 2017;240:138-144. doi: 10.1016/j.ijcard.2017.05.014.
• 6. IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0.Armonk, NY: IBM Corp
• 7. Brescia AA, Ward ST, Watt TMF, Rosenbloom LM, Baker M, Khan S, et al. Outcomes of Guideline-Directed Concomitant Annuloplasty for Functional Tricuspid Regurgitation. Ann Thorac Surg. 2020;109(4):1227-1232. doi:10.1016/j.athoracsur.2019.07.035.
• 8. Guenther T, Mazzitelli D, Noebauer C, Hettich I, Tassani-Prell P, Voss B, et al. Tricuspid valve repair: is ring annuloplasty superior? Eur J Cardiothorac Surg. 2013;43(1):58-65; discussion 65. doi: 10.1093/ejcts/ezs266. 9. Czapla J, Claus I, Martens T, Philipsen T, Van Belleghem Y, François K, et al. Midterm Comparison Between Different Annuloplasty Techniques for Functional Tricuspid Regurgitation. Ann Thorac Surg. 2022;114(1):134-141. doi: 10.1016/j.athoracsur.2021.07.073.
• 10. Parolari A, Barili F, Pilozzi A, Pacini D. Ring or suture annuloplasty for tricuspid regurgitation? A meta-analysis review. Ann Thorac Surg. 2014;98(6):2255-63. doi: 10.1016/j.athoracsur.2014.06.10