De Vega tricuspid valve annuloplasty – a rightly neglected surgical technique?

Introduction
There is a lot of discussion about the best surgical technique for tricuspid valve (TV) regurgitation in patients undergoing an operation for primary mitral valve disease.

Aim
To review and compare our results and experiences regarding the two main surgical strategies: tricuspid valve annuloplasty with a prosthetic ring (RING group) and suture annuloplasty (De Vega group).

Material and methods
We reviewed 570 patients who underwent TV surgery between 2000 and 2016 with either ring annuloplasty (RING group: n = 490 (85.9%)) or De Vega suture annuloplasty (De Vega group: n = 69 (12.1%)). The aetiology of TV insufficiency was secondary in 96.3% (538/559) of the patients, but 47.6% of the patients with primary aetiology had endocarditis of the permanent pacemaker stimulating wires.

Results
The age of the two study groups was similar (p = 0.6589), with a mean age of 66.7 years for the ring annuloplasty group and 67.9 years for the De Vega suture technique. The overall 30-day mortality was 10.9% (n = 61) (RING group n = 58 (11.8%) and De Vega group n = 3 (4.3%)). Ten years after TV surgery with either ring annuloplasty or the De Vega suture technique, 5.8% of patients in both study groups presented with a recurrence of severe tricuspid regurgitation ≥ 3.

Conclusions
Outcomes of tricuspid valve repair did not differ in terms of long-term stability and durability between the two evaluated techniques.