Tricuspid valve repair with a ring annuloplasty

Introduction: Repairing is the most common surgical treatment for tricuspid regurgitation. We analyze the results of tricuspid valve repair using a prosthetic ring. Methods: Retrospective review in patients with tricuspid regurgitation (at least severe), isolated or concomitant with left-sided valve disease, undergoing repair using a semi-rigid annuloplasty ring. Results: 182 patients were analyzed, with a median postoperative follow-up of 61 months. 16.5% had massive tricuspid regurgitation and in 90% of the cases the etiology was functional. Age over 70 years, NYHA functional class >= III, hyponatremia, and concomitant mitroaortic surgery were identified as risk factors for mortality. The worst preoperative functional class and anemia were associated with postoperative right heart failure. During follow-up, patients with massive tricuspid regurgitation had significantly higher mortality and recurrent tricuspid regurgitation. Preoperative anemia, mild hyponatraemia, and higher preoperative tricuspid annulus diameter were risk factors related to right heart failure during followup. Conclussions: The mortality of tricuspid repair with semi-rigid annuloplasty ring increased in elderly patients, with a worse functional class, concomitant mitroaortic disease and incipient right ventricular dysfunction. Correction of anemia could reduce the risk of postoperative right heart failure. In patients with massive tricuspid regurgitation, prosthetic valve replacement or complex tricuspid valve repairing will be chosen to avoid recurrence and improve survival and quality of life. (c) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).