Outcome of MC3 ring annuloplasty for moderate and severe functional tricuspid regurgitation associated with rheumatic mitral valve disease

Abstract

Background
To evaluate early and midterm outcomes of tricuspid ring annuloplasty using three-dimensional (3D) MC3 ring for treatment of functional tricuspid regurgitation (FTR) during mitral valve replacement for rheumatic valve disease.


Results

This prospective study included 105 patients who underwent repair for ≥ moderate tricuspid regurgitation (TR) during mitral valve replacement for rheumatic valve disease. Between January 2016 and December 2018, a group of 23 patients who underwent ring annuloplasty with Edward MC3 rings was compared to another group of 82 patients who underwent standard suture (DeVega) repair. The primary outcome was residual TR (≥ moderate TR). During an average follow-up period of 18.84 ± 9.90 months (range 3–33 months), the preoperative grade of TR improved significantly in both groups. The postoperative mean of TR in the MC3 group was significantly lower than that in the DeVega group (0.17 ± 0.49 versus 0.77 ± 0.93,
P
 = 0.004). The rate of TR recurrence (≥ 2+ TR) was significantly higher after MC3 ring annuloplasty (4.3% versus 23.1%,
P
 = 0.03). Freedom from mild TR was 30.5% in the DeVega group and 61% in the ring annuloplasty group (
P
 = 0.007). Freedom from residual TR was 76.8% in the DeVega group and 95.7% in the ring annuloplasty group (
P
 = 0.04)
.



Conclusions
The use of MC3 rings is a safe and effective alternative to DeVega repair for the management of FTR. However, further evaluation of long-term durability is recommended.