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.