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Ann Thorac Surg 2006;81:2273-2277
© 2006 The Society of Thoracic Surgeons

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New technology

A Three-Dimensional Ring Annuloplasty for the Treatment of Tricuspid Regurgitation

Department of Cardiothoracic Surgery, Mount Sinai Hospital, New York, New York

Accepted for publication December 12, 2005.

^_* Address correspondence to Dr Filsoufi, Cardiac Valve Center, Department of Cardiothoracic Surgery, Mount Sinai Medical Center, 1190 Fifth Ave, Box 1028, New York, NY 10029; (Email: farzan.filsoufi{at}mountsinai.org).

PURPOSE: Significant functional tricuspid regurgitation should be corrected in patients undergoing surgery for left-sided valvular diseases. Several clinical studies have shown the superiority of the remodeling annuloplasty over other repair techniques. Herein we report our early experience with a new three-dimensional remodeling prosthetic ring (Edwards MC³ annuloplasty system [Edwards LifeSciences, Irvine, CA]).

DESCRIPTION: From June 2002 to November 2004, 75 patients with functional tricuspid regurgitation (mean, 3.1 ± 0.9) underwent tricuspid valve repair with this new prosthesis. Concomitant procedures were mitral valve repair (70%), replacement (26%), aortic valve replacement (10%), coronary artery bypass grafting (13%), and left atrial maze (34%). Median predicted EuroScore mortality was 21% (r = 3 to 62).

EVALUATION: Operative mortality was 5.3% (n = 4). Pre-discharge echocardiography showed significant decrease in tricuspid regurgitation to 0.3 ± 0.4 (p < 0.001). Forty-five patients had follow-up transthoracic echocardiography after a median of 16 months (range, 4 to 34) demonstrating a stable result (mean tricuspid regurgitation, 0.3 ± 0.5). There were no cases of ring dehiscence, prosthetic ring endocarditis, or thromboembolic events.

CONCLUSIONS: This new three-dimensional ring is easy to implant, corrects tricuspid regurgitation effectively, and provides good short-term clinical and echocardiographic results. Long-term evaluation, however, is necessary to determine the stability of tricuspid valve repair using the MC³ annuloplasty system.

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Invited commentary

Randy M. Stevens and Tomas A. Salerno
Ann. Thorac. Surg. 2006 81: 2277-2278. [Extract] [Full Text] [PDF]

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