Significance of Effective Height and Mechanism of Regurgitation in Tricuspid Aortic Valve Repair

BACKGROUND Isolated repair of the regurgitant tricuspid aortic valve has become an increasingly practiced alter-native to replacement, even though durability data are scarce. We analyzed the midterm results of tricuspid aortic valve repair to determine whether the mechanism of regurgitation or operative technique influences the results.METHODS Between December 1997 and August 2014, 264 patients underwent isolated tricuspid aortic valve repair in our institution. The mean age was 59 +/- 16 years; 77% (n = 203) were male. Clinical and operative data were recorded. The patients were observed clinically and echocardiographically.RESULTS Survival was 76.7% +/- 3.5% after 10 years and 57.2% +/- 11.5% after 15 years (median, 224 months). Intra-operative measurement of effective height was significantly associated with improved long-term survival (P = .001). Cumulative freedom from reoperation was 88.1% +/- 2.1% after 5 years and 73.3% +/- 4.2% after 10 years. Freedom from recurrent aortic regurgitation 2D was 85.9% +/- 5.2% after 5 years and 66.9% +/- 5.2% after 10 years. Freedom from reoperation was significantly higher in patients with cusp prolapse compared with retraction as the primary regurgitation mechanism (P = .041). The use of circular annuloplasty had no significant influence on survival or durability.CONCLUSIONS Long-term survival after tricuspid aortic valve repair is good, considering the age of the patients. Repair of cusp retraction has a poorer durability compared with repair of prolapse. The use of effective height in tricuspid aortic valve repair is associated with improved survival. (c) 2023 by The Society of Thoracic Surgeons

Automated summary

Survival after tricuspid aortic valve repair is good, considering the age of the patients. Repair of cusp retraction has a poorer durability compared with repair of prolapse. The use of effective height in tricuspid aortic valve repair is associated with improved survival.