AN APPRAISAL OF DE VEGA ANNULOPLASTY IN FUNCTIONAL TRICUSPID REGURGITATION
Objective: To assess the outcome of DeVega annuloplasty technique for Functional Tricuspid Regurgitation (FTR) secondary to left sided Valvular Heart Disease.
Study Design: Descriptive study. Place and Duration of Study: Department of adult cardiac surgery, armed forces institute of cardiology and national institute of heart diseases, Rawalpindi, from Mar 2009 to Jan 2018, including 30 months of follow-up.
Methodology: Sixty-three consecutive cases requiring surgery for mitral and/or aortic valve disease and having moderate to severe FTR or mild FTR with dilated tricuspid annulus were included in this study. De Vega annuloplasty of the tricuspid valve was done in addition to mitral valve replacement in 45 patients (71.43%), aortic valve replacement in 4 (6.35%) and combined mitral and aortic valve replacement in 14 (22.22%). All patients were followed-up for peri-operative mortality, degree of tricuspid regurgitation (TR) after surgery and before discharge from hospital, and New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF), survival, and severity of residual or recurrent TR for a mean period of 30 months.
Results: There were 2 (3.17%) early deaths. Twenty-one patients (33.33%) had no TR, 38 (60.32%) had mild TR and 4 (6.35%) had moderate TR, in the early post-operative period. One patient died 19 months after surgery due to prosthetic valve thrombosis and another died 25 months after surgery due to an is chaemic stroke. At 30 months most patients showed improvement in NYHA class, LVEF and degree of TR when compared with the pre-operative status.
Conclusion: We conclude from this study that the De Vega technique of tricuspid annular repair is an effective method of treating FTR secondary to mitral and aortic valve disease, with acceptable short- and medium-term results.