Repair of tricuspid regurgitation: comparison between suture annuloplasty and ring annuloplasty: an ambispective observational study

Objective and background: We undertook this study to evaluate and compare the outcome of the DeVega suture annuloplasty and ring annuloplasty of Tricuspid valve to find out the better option in the setting of RHD.
Method: A total of 100 (N=100), patients of Rheumatic Heart Disease (RHD) with left heart valve involvement and associated with severe functional Tricuspid Regurgitation (TR) and moderate to severe Pulmonary Artery Hypertension (PAH), operated during last five years were included in our study. Group 1 patient were treated by ring annuloplasty of TV and group 2 were treated by modified de vega suture annuloplasty. Patients were evaluated and analysed retrospectively as well as prospectively followed up to see the difference in outcome between the two groups in terms of the clinical and 2D echocardiography changes.
Result: There was a statistically significant difference in terms of postoperative residual TR and recurrence of TR in both the groups. In group 1 intra operative TEE showed 26(52%) had no TR, 22(44%) had trivial TR, and 2(4%) had mild TR, at immediate postop 24(48%) had no TR, 24(48%) had trivial TR and only 2(4%) had mild TR. Whereas , in group 2, intraoperative TEE showed 3(6%) had no TR, 2(4%) had trivial TR, 38(76%) had mild TR and 7(14%) had severe TR, and at immediate post op before the discharge, 2D echocardiography showed 4(8%) had trivial TR, 30(60%) had mild TR, and 16(32%) had moderate TR, with similar results at 3, 6 and 12 month follow up, with p value of <0.001. Conclusion: The ring annuloplasty is a better and effective method to treat severe functional TR in the setting of RHD with left heart valve disease, compared to DeVega suture annuloplasty.