Tratamentul chirurgical în valvulopatiile tricuspidiene dobândite

Abstract

Background: To establish risk factors that determines recurrence after reconstructive correction in functional tricuspid insufficiency (FTI). Material and method: During last 20 years, 1754 patient needed tricuspid correction in acquired valve disease and functional lesion prevailed in 1546 (88.1%) of them. Diverse tricuspid annuloplasty techniques were performed: De Vega – 642 cases, Cabrol – 587, M. Antunes – 56, Boyd – 16, Carpentier ring – 245. Additional procedures were applied to 354 cases as: cleft defect suture – 276, cusps surface enlargement with autologous pericardium – 22, Alfiery procedure – 12, vegetation resection – 9, neocordage – 4, papillary muscle approximation – 1. The effectiveness of reconstructive surgery was measured with the help of Echocardiography. Results: Hospital lethality constituted 2.8% (43 cases). Residual regurgitations of I-II grade were found at 231 (14.9%) patients. Carpantier ring annuloplasty assured a durable correction, except patients with considerable cusps retraction. Tricuspid insufficiency recurrence through semicircular suture dehiscence constituted 12.1% (78 cases) after De Vega annuloplasty and 1.5% (9 cases) after Cabrol technique, 52 patients needed reoperation. Conclusion: Stability results after FTI correction depend on preoperative valve complex, performed surgical technique, hemodynamic evolution within a long period.