Concomitant mitral valve replacement and tricuspid valvuloplasty for severe mitral stenosis

X.-D. Hou, F. Ding, X.-K. Wang, X.-G. Liu, K. Yi, P. Zhang, T. You

Department of Cardiac Surgery, Gansu Province People’s Hospital, Lanzhou, Gansu Province, China. houxd2013@126.com

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• Cardiology

OBJECTIVE: The purpose of this work is to analyze the clinical results of treating severe mitral stenosis (MS) with mild to moderate functional tricuspid regurgitation (FTR) with mitral valve replacement (MVR) alone or together with two different methods of tricuspid valvuloplasty (TVP).

PATIENTS AND METHODS: We split 132 patients into three groups: simple MVR with 47 cases (control group), MVR+ TVP (De Vega loop reduction) with 45 cases (observation group 1) and MVR+ TVP (Edwards MC3 tricuspid forming ring implantation) with 40 cases (observation group 2).

RESULTS: As expected, surgery for both observation groups was longer than for the control group, but we found no differences in aortic clamping time, cardiopulmonary bypass time, perioperative complications, and postoperative hospital stay. We found significantly fewer complications in both observation groups compared to the control group. After surgery, the diameter of the tricuspid valve ring and the maximum reflux bundle were significantly lower in the observation groups compared to the control group.

CONCLUSIONS: Overall, the long-term clinical effect of combined MVR and TVP to treat severe MS with mild to moderate FTR is better than using the simple MVR procedure. Our results also suggest that the Edwards MC3 tricuspid forming ring implantation is superior to the De Vega loop reduction.

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