DE VEGAS ANNULOPLASTY FOR TRICUSPID REGURGITATION

A total of 337 patients underwent a mitral or combined mitral and aort ic valve operation at the Oulu University Hospital between 1986 and 19 92. Of these, 30 (8.9 %) patients had De Vega's semicircular annulopla sty performed because of tricuspid regurgitation (TR) which was consid ered functional in nature. There were five (16.6 %) early and seven (2 3.3 %) late deaths during the follow-up period of 10 to 71 months. The preoperative mean New York Heart Association (NYHA) functional class was 3.4, and at follow-up 13 (76.5 re) of the survivors were in NYHA C lass I or II. The actuarial survival rate was 37.6 % at five years. Al l the survivors were evaluated echocardiographically and the TR was co nsidered mild in 56.3 %, moderate in 25.0 % and severe in 18.7 % of th e cases. Tricuspid annuloplasty using De Vega's semicircular suture te chnique is a simple and effective procedure in patients with mild to m oderate regurgitation. In patients with massive regurgitation, which i s usually associated with a massively dilated tricuspid annulus and pu lmonary hypertension, annuloplasty should be reinforced using a ring t echnique. Tricuspid valve replacement is hardly ever needed in the tre atment of functional tricuspid regurgitation.