MC3 Ring for Functional Tricuspid Valve Regurgitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHUYan ,  WANGHui-shan , JINYan

Department of Cardiovascular Surgery, Te General Hospital of Shengyang Military, Shenyang 110016, P. R. China;

Corresponding author：

WANGHui-shan, Email: 13309888139@163.com

Keywords：

MC3 annuloplasty ring; Tricuspid regurgitation; Tricuspid annuloplasty

DOI：

10.7507/1007-4848.20150280

Video：

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Objective To assess the method and the results of tricuspid annuloplasty performed(TVP) with the Edwards MC3 ring. Methods We retrospectively analyzed the clinical data of 312 patients with functional tricuspid regurgitation(FTR) secondary to left-sided valve disease in our hospital from June 2012 through May 2014. There were 147 males and 165 females at mean age of 55.7±7.3 years. Results There was no death in the patients because of the planting of MC3 ring. The mean follow-up rate was 99.4%(310/312) for 2 patients immigration abroad. The follow-up time was 0-24(14.2±4.7) months. The ultrasoundcardiogram showed that all the ejection fraction(EF) of right ventricle improved compared with preoperation(P<0.05). The pulmonary artery systolic pressure(SPAP), both internal diameter and regurgitation volume of right ventricle were decreased(P<0.05). In the 310 patients, 302 patients(97.4%) were with the TR class 0-Ⅰ, 5 patients(1.6%) with class Ⅱ, 3 patients(1.0%) with class Ⅲ. There was no severe TR or no patient with reoperation. Conclusion The MC3 ring is easy for planting and has good repeatability, which provides stable and satisfactory results for plasty of the tricuspid annulus with seldom residue or recurrent TR.

Citation： ZHUYan, WANGHui-shan, JINYan. MC3 Ring for Functional Tricuspid Valve Regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(12): 1122-1127. doi: 10.7507/1007-4848.20150280 Copy

1.	Sukmawan R, Watanabe N, Ogasawara Y, et al. Geometric changes of tricuspid valve tenting in tricuspid regurgitation secondary to pulmonary hypertension quantified by novel system with transthoracic real-time 3-dimensional echocardiography. J Am Soc Echocardiogr, 2007, 20(5):470-476.
2.	Ton-Nu TT, Levine RA, Handschumacher MD, et al. Geometric determinants of functional tricuspid regurgitation:Insights from 3-dimensional echocardiography. Circulation, 2006, 114(2):143-149.
3.	Van de Veire NR, Braun J, Delgado V, et al. Tricuspid annuloplasty prevents right ventricular dilatation and progression of tricuspid regurgitation in patients with tricuspid annular dilatation undergoing mitral valve repair. J Thorac Cardiovasc Surg, 2011, 141(6):1431-1439.
4.	Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr, 200, 16(7):777-802.
5.	Al-Atassi T, Toeg H, Chan V, et al. Current readings:status of tricuspid valve repair. Semin Thorac Cardiovasc Surg, 2013, 25(1):30-37.
6.	Shiran A, Najjar R, Adawi S, et al. Risk factors for progression of functional tricuspid regurgitation. Am J Cardiol, 2014, 113(6):995-1000.
7.	Murashita T, Okada Y, Kanemitsu H, et al. Fate of functional tricuspid regurgitation after mitral valve repair for degenerative mitral regurgitation. Circ J, 2013, 77(9):2288-2294.
8.	Dreyfus GD, Corbi PJ, Chan KM, et al. Secondary tricuspid regurgitation or dilatation:which should be the criteria for surgical repair? Ann Thorac Surg, 2005, 79(1):127-132.
9.	Fukuda S, Song JM, Gillinov AM. Tricuspid valve tethering predicts residual TR after tricuspid annuloplasty. Circulation, 2005, 111(8):975-979.
10.	Seo HS, Ha JW, Moon JY, et al. Right ventricular remodeling and dysfunction with subsequent annular dilatation and tethering as a mechanism of isolated tricuspid regurgitation. Circ J, 2008, 72(10):1645-1649.
11.	Ooka T, Matsui Y. Tricuspid valve surgery based on the mechanisms of functional tricuspid regurgitation. Ann Thorac Cardiovasc Surg, 2012, 18(4):293-296.
12.	Carpentier A. Cardiac valve surgery-the "French correction." J Thorac Cardiovasc Surg, 1983, 86(3):323-337.
13.	Ghanta RK, Chen R, Narayanasamy N, et al. Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation:Midterm results of 237 consecutive patients. J Thorac Cardiovasc Surg, 2007, 133(1):117-126.
14.	Roshanali F, Saidi B, Mandegar MH, et al. Echocardiographic approach to the decision-making process for tricuspid valve repair. J Thorac Cardiovasc Surg, 2010, 139(6):1483-1487.
15.	Navia JL, Nowicki ER, Blackstone EH, et al. Surgical management of secondary tricuspid valve regurgitation:annulus, commissure, or leaflet procedure? J Thorac Cardiovasc Surg, 2010, 139(6):1473-1482.
16.	Badano LP, Muraru D, Enriquez-Sarano M. Assessment of functional tricuspid regurgitation. Eur Heart J, 2013, 34(25):1875-1885.
17.	Rogers JH1, Bolling SF. Surgical approach to functional tricuspid regurgitation:should we be more aggressive? Curr Opin Cardiol, 2014, 29(2):133-139.
18.	Huang X, Gu C, Men X, et al. Repair of functional tricuspid regurgitation:comparison between suture annuloplasty and rings annuloplasty. Ann Thorac Surg, 2014, 97(4):1286-1292.
19.	Fukuda S, Saracino G, Matsumura Y, et al. 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(1 Suppl):I492-I498.
20.	Teman NR, Huffman LC, Krajacic M, et al. "Prophylactic" tricuspid repair for functional tricuspid regurgitation. Ann Thorac Surg, 2014, 97(5):1520-1524.
21.	Filsoufi F, Chikwe J, Carpentier A. Rationale for remodelling annuloplasty to address functional tricuspid regurgitation during left-sided valve surgery. Eur J Cardiothorac Surg, 2015, 47(1):1-3.
22.	Pfannm€uller B, Doenst T, Eberhardt K, et al. Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings. J Thorac Cardiovasc Surg, 2012, 143(5):1050-1055.
23.	Filsoufi F, Salzerg SP, Coutu M, et al. A three-dimensional ring annuloplasty for the treatment of tricuspid regurgitation. Ann Thorac Surg, 2006, 81(6):2273-2277.
24.	Ghoreishi M, Brown JM, Stauffer CE, et al. Undersized tricuspid annuloplasty rings optimally treat functional tricuspid regurgitation. Ann Thorac Surg, 2011, 92(1):89-95.

1. Sukmawan R, Watanabe N, Ogasawara Y, et al. Geometric changes of tricuspid valve tenting in tricuspid regurgitation secondary to pulmonary hypertension quantified by novel system with transthoracic real-time 3-dimensional echocardiography. J Am Soc Echocardiogr, 2007, 20(5):470-476.
2. Ton-Nu TT, Levine RA, Handschumacher MD, et al. Geometric determinants of functional tricuspid regurgitation:Insights from 3-dimensional echocardiography. Circulation, 2006, 114(2):143-149.
3. Van de Veire NR, Braun J, Delgado V, et al. Tricuspid annuloplasty prevents right ventricular dilatation and progression of tricuspid regurgitation in patients with tricuspid annular dilatation undergoing mitral valve repair. J Thorac Cardiovasc Surg, 2011, 141(6):1431-1439.
4. Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr, 200, 16(7):777-802.
5. Al-Atassi T, Toeg H, Chan V, et al. Current readings:status of tricuspid valve repair. Semin Thorac Cardiovasc Surg, 2013, 25(1):30-37.
6. Shiran A, Najjar R, Adawi S, et al. Risk factors for progression of functional tricuspid regurgitation. Am J Cardiol, 2014, 113(6):995-1000.
7. Murashita T, Okada Y, Kanemitsu H, et al. Fate of functional tricuspid regurgitation after mitral valve repair for degenerative mitral regurgitation. Circ J, 2013, 77(9):2288-2294.
8. Dreyfus GD, Corbi PJ, Chan KM, et al. Secondary tricuspid regurgitation or dilatation:which should be the criteria for surgical repair? Ann Thorac Surg, 2005, 79(1):127-132.
9. Fukuda S, Song JM, Gillinov AM. Tricuspid valve tethering predicts residual TR after tricuspid annuloplasty. Circulation, 2005, 111(8):975-979.
10. Seo HS, Ha JW, Moon JY, et al. Right ventricular remodeling and dysfunction with subsequent annular dilatation and tethering as a mechanism of isolated tricuspid regurgitation. Circ J, 2008, 72(10):1645-1649.
11. Ooka T, Matsui Y. Tricuspid valve surgery based on the mechanisms of functional tricuspid regurgitation. Ann Thorac Cardiovasc Surg, 2012, 18(4):293-296.
12. Carpentier A. Cardiac valve surgery-the "French correction." J Thorac Cardiovasc Surg, 1983, 86(3):323-337.
13. Ghanta RK, Chen R, Narayanasamy N, et al. Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation:Midterm results of 237 consecutive patients. J Thorac Cardiovasc Surg, 2007, 133(1):117-126.
14. Roshanali F, Saidi B, Mandegar MH, et al. Echocardiographic approach to the decision-making process for tricuspid valve repair. J Thorac Cardiovasc Surg, 2010, 139(6):1483-1487.
15. Navia JL, Nowicki ER, Blackstone EH, et al. Surgical management of secondary tricuspid valve regurgitation:annulus, commissure, or leaflet procedure? J Thorac Cardiovasc Surg, 2010, 139(6):1473-1482.
16. Badano LP, Muraru D, Enriquez-Sarano M. Assessment of functional tricuspid regurgitation. Eur Heart J, 2013, 34(25):1875-1885.
17. Rogers JH1, Bolling SF. Surgical approach to functional tricuspid regurgitation:should we be more aggressive? Curr Opin Cardiol, 2014, 29(2):133-139.
18. Huang X, Gu C, Men X, et al. Repair of functional tricuspid regurgitation:comparison between suture annuloplasty and rings annuloplasty. Ann Thorac Surg, 2014, 97(4):1286-1292.
19. Fukuda S, Saracino G, Matsumura Y, et al. 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(1 Suppl):I492-I498.
20. Teman NR, Huffman LC, Krajacic M, et al. "Prophylactic" tricuspid repair for functional tricuspid regurgitation. Ann Thorac Surg, 2014, 97(5):1520-1524.
21. Filsoufi F, Chikwe J, Carpentier A. Rationale for remodelling annuloplasty to address functional tricuspid regurgitation during left-sided valve surgery. Eur J Cardiothorac Surg, 2015, 47(1):1-3.
22. Pfannm€uller B, Doenst T, Eberhardt K, et al. Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings. J Thorac Cardiovasc Surg, 2012, 143(5):1050-1055.
23. Filsoufi F, Salzerg SP, Coutu M, et al. A three-dimensional ring annuloplasty for the treatment of tricuspid regurgitation. Ann Thorac Surg, 2006, 81(6):2273-2277.
24. Ghoreishi M, Brown JM, Stauffer CE, et al. Undersized tricuspid annuloplasty rings optimally treat functional tricuspid regurgitation. Ann Thorac Surg, 2011, 92(1):89-95.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

MC3 Ring for Functional Tricuspid Valve Regurgitation

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