Outcomes following use of a modified Duran ring tricuspid valve reconstruction procedure for secondary tricuspid regurgitation.

BACKGROUND Tricuspid valve (TV) repair using ring annuloplasty is reportedly to be superior to suture annuloplasty for treating tricuspid regurgitation (TR). The Duran ring TV annuloplasty technique was modified in order to reduce the risk of complete atrioventricular block and aortic valve injury and the outcomes are reported here. The modification involved not suturing half of the septal annulus. METHODS AND RESULTS Between January 1998 and July 2007, 219 patients diagnosed with secondary TR underwent TV repair using a modified Duran ring procedure. The mean patient age was 54.2+/-12.7 years, and 65 (29.7%) patients were male. The median follow-up duration was 35.8 months (range, 0.03-122.6 months). The mean ring size was 27.4+/-2.0 mm. The prevalence of 3+ or 4+ regurgitation was 9.5% (21/218) at 1 week postoperatively, and 9.4% at more than 2 years postoperatively (mean, 57 months; 96 patients assessed). The in-hospital mortality rate was 1.4% (3/219). The overall survival rate was 95+/-1.5% at 1 year, 86.2+/-3.0% at 5 years, and 79.9+/-4.2% at 8 years. Multivariate analysis showed that atrial fibrillation at the last follow-up (P<0.001) and cardiopulmonary bypass time (P=0.016) were risk factors for recurrent or persistent significant TR. CONCLUSIONS The modified Duran ring TV repair procedure for secondary TR patients was safe and durable. Notably, postoperative atrial fibrillation was found to be a significant risk factor for recurrent TR.

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