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.