Adjustable tricuspid annuloplasty

Abstract

The methods for repairing functional tricuspid regurgitation (TR) are still controversial. A novel concept of tricuspid annuloplasty for functional TR was developed. A flexible annuloplasty band, through which an expanded polytetrafluoroethylene (ePTFE) thread (CV3) was passed inside the cover cloth, was secured to the tricuspid annulus. Both ends of the ePTFE thread were passed through the right atrial wall. The thread was snared from outside the ejecting heart under observation by a transoesophageal echocardiogram after weaning off the cardiopulmonary bypass. We used this technique in 11 patients with functional TR (mean TR grade: 3.4 ± 0.8). The mean circumference of the annulus after snaring was 86.5 ± 4.6 mm (diameter 27.6 ± 1.5 mm). The postoperative TR at discharge was trivial or 0 in 9 patients and Grade 1 in 2. We concluded that this method has the potential to minimize residual regurgitation. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.