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

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.