Middle and long-term outcomes of non-ring tricuspid annuloplasty in patients with mitral valve replacement

Objective To evaluate the middle-period and long-term outcomes of one-stage non-ring TVP in patients with MVR. Methods 427 patients who received one-stage mechanical MVR and non-ring TVP from January 2005 to January 2009 at Department of Cardiovascular Surgery of West China Hospital; After screening, 400 patients were finally recruited, who reexamined by UCG 10 years after surgery.and recorded UCG data. Results The patients were followed up for 10 years after surgery. Compared with the situation before surgery,RV(mm):21.47 ± 3.14 vs.22.37 ± 3.28,TAEDD(mm):32.18 ± 4.94 vs.35.88 ± 4.07 and TESD(mm):25.90 ± 4.90 vs.28.12 ± 4.12 decreased significantly at 5 years after surgery (P < 0.05). However, RA(mm):49.35 ± 13.05 vs. 50.69 ± 12.90 did not change significantly (P > 0.05). LVEF (%): 61.54 ± 8.23 vs. 57.38 ± 8.87 also increased significantly after surgery (P < 0.05). Compared with the preoperative situation, at 10 years after surgery, RA(mm) was 56.90 ± 12.90, RV (mm) 23.12 ± 4.58, TESD (mm) 28.80 ± 5.14 and LVEF (%) 59.81 ± 8.95, all of which increased significantly (P < 0.05); however, TEDD (mm) was 35.41 ± 5.11, which did not change significantly (P > 0.05). Compared with preoperative situation, the ratios of severity of TR at 5 and 10 years after surgery improved significantly (P < 0.05). Conclusion It is reasonable to use the tricuspid annular diameter in patients with mitral valve disease as an indication for one-stage TVP. The one-stage non-ring TVP is conducive to preventing aggravation of TR, so as to achieve a better long-term outcome. Besides, oral diuretics are recommended to treat TR after surgery for such patients.