COMPARATIVE ANALYSIS OF THE IMMEDIATE RESULTS OF CORRECTION OF SECONDARY TRICUSPID REGURGITATION BY VARIOUS TYPES OF SUPPORT RINGS ACCORDING TO THE DATA OF THE REGISTRY STUDY

Highlights
An analysis of a register study involving patients with mitral and aortic valve defects of various etiologies with concomitant secondary tricuspid insufficiency is presented. All patients underwent correction of the primary affected valves, as well as secondary tricuspid valve insufficiency using support rings of various designs (semi-rigid, rigid and flexible). The results obtained demonstrate the comparable effectiveness of the rings used in terms of freedom from recurrence of tricuspid regurgitation in the early postoperative period, as well as hospital mortality.

Abstract

Aim. To compare short-term outcomes of treatment of functional tricuspid regurgitation (TR) using annuloplasty rings of different types (flexible, semi-rigid and rigid) in patients who had undergone surgery for valvular defects.

Methods. The two-center registry-based study included 708 patients with mitral or aortic valve defects and moderate or severe STR requiring surgical treatment. Exclusion criteria were as follows: organic tricuspid valve regurgitation, age below 18 years. Primary endpoints were as follows: in-hospital mortality, recurrent tricuspid regurgitation (> grade 2) in the early postoperative period.

Results. Of the patients included in this study, 400 (56.4%) patients received a semi-rigid ring made by “NeoCor” (the NeoCor group), 154 (21.8%) patients received a flexible ring made by “MedInj” (the Flexible group), and 154 (21.8%) patients received a rigid ring made by “MedInj” (the Rigid group). Most patients presented with the clinical manifestations of chronic heart failure of The New York Heart Association (NYHA) functional class II/III. However, in the NeoCor group the majority of patients presented with (NYHA) functional class IV. Rheumatic valve disease prevailed in the NeoCor group, and connective tissue disorders prevailed in the Flexible and Rigid groups. Initially, in the NeoCor group, STR was marked by a predominance of severe regurgitation. The most frequently reported perioperative complications in the analyzed sample were the need for inotropic support for more than 24 hours, development of atrial fibrillation, hydro- or hemothorax, implantation of permanent pacemakers, prolonged mechanical ventilation. In-hospital mortality did not differ between the groups and amounted to 1.5% in the NeoCor group, 2.6% in the Flexible group and 1.9% in the Rigid group. Echocardiographic examination in the postoperative period did not reveal > grade 2 tricuspid regurgitation in any of the groups.

Conclusion. According to the results of the study, semi-rigid, flexible and rigid annuloplasty rings are equally effective in treating functional TR.

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