A comparative study on tricuspid valve repair using De Vega's annuloplasty technique and modified De Vega's technique using polytetrafluoroethylene band

Anbukumar Palanisamy, Karthikeyan Bose, P. Rani, T. Muthu Vijayan, Marwin Manoa Baylis


Background: The aim of the study was to compare the outcomes of tricuspid valve repair (TVR) with repair techniques for functional tricuspid regurgitation (TR), DeVega's technique and modified DeVega's technique using Polytetrafluoroethylene band.

Methods: A total of 37 patients who underwent TVR at Madurai Medical College from September 2019 to November 2021 formed into Group A, consisting of 16 patients who had DeVega's procedure done and Group B, consisting of 21 patients who had modified DeVega's procedure using Polytetrafluoroethylene band. In addition, in 80% of patients with rheumatic heart disease (RHD), concurrent surgeries included mitral valve replacement (MVR) and double valve replacement (DVR) in 20% of patients. Clinical and echocardiographic follow-up data were also collected for analysis.

Results: All 37 patients were examined and followed up after 3 months and 6 months. Group A De Vegas- 9 out of 16 patients (56%) had mild TR,4 out of 16 (25%) patients had moderate TR, and 3 out of 16 (19%) patients had severe TR. Group B Modified De Vegas- 16 out of 21 patients (76%) had mild TR, 4 out of 21 (19%) patients had moderate TR, and 2 out of 21 (5%) had severe TR.

Conclusions: Tricuspid valve annuloplasty utilizing a modified De Vega's procedure with a polytetrafluoroethylene band was shown to be beneficial when patients were followed for three and six months, respectively.


Tricuspid valve, De Vega tricuspid annuloplasty, Outcome

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Anyanwu AC, Chikwe J, Adams DH. Tricuspid valve repair for treatment and prevention of secondary tricuspid regurgitation in patients undergoing mitral valve surgery. CurrCardiol Rep. 2008;10:110-7.

Shiina A, Seward JB, Edwards WD, Hagler DJ, Tajik AJ. Two-dimensional echocardiographic spectrum of Ebstein's anomaly: detailed anatomic assessment. J Am Coll Cardiol. 1984;3(2):356-70.

Silver MD, Lam JH, Ranganathan N. Morphology of the human tricuspid valve. Circulation 1971;43:333-48.

Fukuda S, Saracino G, Matsumura Y. Three-dimensional geometry of the tricuspid annulus in healthy subjects and in patients with functional tricuspid regurgitation: a real-time, 3-dimensional echocardiographic study. Circulation. 2006;114:I492-8.

Colombo T, Russo C, Ciliberto GR. Tricuspid regurgitation secondary to mitral valve disease: tricuspid annulus function as guide to tricuspid valve repair. Cardiovasc Surg. 2001;9:369-77.

McCarthy PM, Bhudia SK, Rajeswaran J. Tricuspid valve repair: durability and risk factors for failure. J Thorac Cardiovasc Surg. 2004;127:674-85.

Nath J, Foster E, Heidenreich PA. Impact of tricuspid regurgitation on long-term survival. J Am Coll Cardiol. 2004;43:405-9.

Song H, Kim MJ, Chung CH. Factors associated with development of late significant tricuspid regurgitation after successful left-sided valve surgery. Heart. 2009;95:931-6.

Kara I, Koksal C, Cakalagaoglu C. Recurrent tricuspid insufficiency: is the surgical repair technique a risk factor? Tex Heart Inst J. 2013;40:34-41.

Matsuyama K, Matsumoto M, Sugita T. Predictors of residual tricuspid regurgitation after mitral valve surgery. Ann Thorac Surg. 2003;75:1826-8.

Kusajima K, Fujita T, Hata H, Shimahara Y, Miura S, Kobayashi J. Long-term echocardiographic follow-up of untreated 2+ functional tricuspid regurgitation in patients undergoing mitral valve surgery. Interact Cardiovasc Thorac Surg. 2016;23:96-103.

Tornos Mas P, Rodríguez-Palomares JF, Antunes MJ. Secondary tricuspid valve regurgitation: a forgotten entity. Heart. 2015;101:1840-8.

Bernal JM, Morales D, Revuelta C. Reoperations after tricuspid valve repair. J Thorac Cardiovasc Surg. 2005;130:498-503.

Cohn LH. Tricuspid regurgitation secondary to mitral valve disease: when and how to repair. J Card Surg. 1994;9:237-41.

Benedetto U, Melina G, Angeloni E. Prophylactic tricuspid annuloplasty in patients with dilated tricuspid annulus undergoing mitral valve surgery. J Thoracic Cardiovas Surg. 2012;143:632-8.

Van de Veire NR, Braun J, Delgado V. Tricuspid annuloplasty prevents right ventricular dilatation and progression of tricuspid regurgitation in patients with tricuspid annular dilatation undergoing mitral valve repair. J Thor Cardiovas Surg. 2011;141:1431-9.

Nemes A, Piros GÁ, Domsik P. Changes in mitral annular morphology and function in young patients with type 1 diabetes mellitus-results from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study. Quant Imag Med Surg. 2015;5:815-21.

Duran CMG, Ubago JLM. Clinical and hemodynamic performance of a totally flexible prosthetic ring for atrio-ventricular valve reconstruction. Ann Thorac Surg. 1976;22:458-63.

Antunes MJ, Girdwood RW. Tricuspid annuloplasty: a modified technique. Ann Thorac Surg. 1983;35:676-8.