De Vega's annuloplasty for tricuspid regurgitation

A total of 337 patients underwent a mitral or combined mitral and aortic valve operation at the Oulu University Hospital between 1986 and 1992. Of these, 30 (8.9 %) patients had De Vega's semicircular annuloplasty performed because of tricuspid regurgitation (TR) which was considered functional in nature. There were five (16.6 %) early and seven (23.3 %) 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 Class I or II. The actuarial survival rate was 37.6 % at five years. All the survivors were evaluated echocardiographically and the TR was considered mild in 56.3 %, moderate in 25.0 % and severe in 18.7 % of the cases. Tricuspid annuloplasty using De Vega's semicircular suture technique is a simple and effective procedure in patients with mild to moderate regurgitation. In patients with massive regurgitation, which is usually associated with a massively dilated tricuspid annulus and pulmonary hypertension, annuloplasty should be reinforced using a ring technique. Tricuspid valve replacement is hardly ever needed in the treatment of functional tricuspid regurgitation.