Abstract

Controversy exists regarding the indication and method of repair of functional tricuspid regurgitation (TR) in patients undergoing mitral valve surgery. Whereas the American College of Cardiology/American Heart Association guidelines recommend tricuspid repair in the setting of severe TR, tricuspid repair is advised for less than severe TR in the setting of annular dilation or pulmonary hypertension. Although multiple repair strategies exist, the use of a ring annuloplasty (semirigid remodeling rings vs flexible bands) is the preferred method of therapy to avoid short- and long-term recurrence of TR. The new Tri-Ad Adams annuloplasty ring combines elements of semirigid and flexible bands that will not only allow for annular remodeling in the region of the right ventricular free wall but also potentially reduce injury to the conduction system with its flexible and "open" ends. In this article, we discuss the rational for an aggressive approach to functional tricuspid regurgitation, and show our initial clinical experience with the Tri-Ad Adams annuloplasty ring.

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Publisher Full Text

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Authors

Milla F, Castillo JG, Varghese R, Chikwe J, Anyanwu AC, Adams DH

Institution

Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, NY 10029-102, USA.

Source

The Journal of thoracic and cardiovascular surgery 143:4 Suppl 2012 Apr pg S71-3

MeSH

Cardiac Valve Annuloplasty
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Humans
Patient Selection
Practice Guidelines as Topic
Prosthesis Design
Recurrence
Treatment Outcome
Tricuspid Valve
Tricuspid Valve Insufficiency

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22281022