TREATMENT OF FUNCTIONAL TRICUSPID REGURGITATION BY BICUSPIDALIZATION ANNULOPLASTY DURING MITRAL-VALVE SURGERY

Background and aims of the study: Surgical treatment of functional tri cuspid regurgitation associated with advanced valvular disease remains controversial, mainly due to the difficulty in choosing between valve replacement or reconstructive surgery. Failure to correct tricuspid r egurgitation during valvular surgery carries a poor prognosis, as reop eration may represent a significant risk to the patient. Thus correct tricuspid valve surgery is vital to achieve improved early and long-te rm clinical results. Methods: A total of 142 patients underwent concom itant tricuspid annuloplasty with mitral valve replacement and their c linical outcome was assessed. Results: Overall hospital mortality rate was 11.3%. Seven patients died during follow up. The overall actuaria l survival rate for 10 years was 74.1 +/- 14.2%. Postoperatively, 75.8 % of the patients had no residual tricuspid insufficiency, while 24.2% had first-or second-degree tricuspid insufficiency and were treated m edically. All patients were in NHYA functional class I or II postopera tively. Conclusion: Clinically, it is important to assess the severity of functional tricuspid insufficiency before and/or during the operat ion. Bicuspidalization annuloplasty for functional tricuspid insuffici ency has provided good results, with a low incidence of reoperation an d significant clinical improvement. The technique could be used in mos t patients with functional tricuspid regurgitation.