Long-term outcomes of tricuspid valve repair; the influence of the annuloplasty prosthesis.

Abstract Background The ideal tricuspid valve annuloplasty (TVA) prosthesis is controversial. This study aimed to compare the effect of rigid versus flexible TVA prostheses on long-term outcomes after repair of functional tricuspid regurgitation (FTR). Methods We included 713 patients who had repair of FTR from 2009 to 2017. Patients were divided into two groups according to the type of TVA prosthesis. Group1 (n=104) included patients who had repair using rigid rings, and group 2 (n=609) included patients with flexible bands. The median age was 53.5 (25th- 75th percentiles: 42.5- 62) years in group1 vs. 56 (45- 65) years in group2 (p=0.11). Propensity score matching identified 91 matched pairs for comparison. Results In the matched pairs, operative mortality was identical (4 (4.4%) in both groups; p ˃0.99). The median follow-up was 55 (28- 83) months. The cumulative incidence of moderate or higher TR in the presence of death as a competing risk was higher in group 2 (SHR: 1.63; p= 0.019 and SHR: 1.6; p= 0.099, before and after matching, respectively). There was a trend of higher pacemaker insertion in group 1 (7(7.69%) vs.3(3.3%); p=0.34) that did not reach statistical significance after matching. There was no significant change in the degree of TR over time between both groups (OR:1.21, p= 0.53 and OR1.75, p= 0.21, before and after matching, respectively). Conclusions Both types of tricuspid valve annuloplasty prostheses had comparable efficacy in the management of FTR; however, freedom from moderate or more TR was higher in the rigid ring group.