Echocardiographic follow-up of tricuspid annuloplasty with a new three-dimensional ring in patients with functional tricuspid regurgitation

Background. A new tricuspid valve (TV) annuloplasty system, the MC3 ring, includes a three-dimensional structure designed to remodel the TV annulus and preserve physiologic annular function. Purpose. We investigated the early- and mid-term outcomes of TV annuloplasty with the MC3 ring. Methods. A total of 136 patients with functional tricuspid regurgitation (TR) had two-dimensional echocardiography before and 5 +/- 5 days after TV annuloplasty with the MC3 ring. Twenty-eight patients were followed for more than 1 year after surgery. Echocardiography was used to assess response to surgical therapy, including measures of cardiac function and geometry and identification of factors predisposing one to recurrent TR. Results. TR severity was improved early after surgery (P < .001). At 5 days after surgery, 16% had TR graded greater than moderate; among patients followed more than 1 year, this figure was 14%. Postoperative TR severity was associated with preoperative TR severity and tethering height. Conclusion: TV annuloplasty with the new physiologic MC3 ring is effective for the management of TR and may be superior to conventional techniques. However, patients with extensive leaflet tethering (> 1.0 cm) require additional maneuvers to ensure valve competence.