Mid-Term Results of Tricuspid Valve Repair for Functional Tricuspid Regurgitation: Ring and Modified Band Annuloplasty

Background: The concurrent repair of functional tricuspid regurgitation (TR) is typically recommended during left-sided heart valve surgery. Several surgical techniques are available, each targeting long-term effectiveness and clinical success. Objective: This study sought to assess the mid-term outcomes of two widely used tricuspid valve repair (TVr) methods: flexible band annuloplasty (FA) and rigid ring annuloplasty (RA). Methods: This retrospective study involved 85 patients who underwent TVr along with left-sided valve surgery. Of these, 53 patients were assigned to the FA group (Group A), and 32 patients to the RA group (Group B). Transthoracic echocardiography was performed at hospital discharge and after a follow-up period of 3.5 ± 0.5 years. Results: The two groups were similar in terms of age, sex, comorbidities, and New York Heart Association functional classification. In Group A, 40 patients received mitral valve replacement (MVR), while 23 patients in Group B underwent the same procedure. Combined mitral and aortic valve replacement (MVR + AVR) was performed in 8 patients in Group A and 6 patients in Group B, while mitral valve repair (MVr) was done in 5 and 3 patients in Groups A and B, respectively. At discharge, moderate residual TR (grade 2) was observed in 11.3% of Group A and 9.4% of Group B. During the mid-term follow-up, TR recurrence (≥ grade 2) was noted in 24.2% of the FA group and 18.6% of the RA group. Univariable analysis indicated that female sex was a predictor of recurrence. Both univariable and multivariable analyses identified residual TR at discharge and the severity of pulmonary hypertension as significant predictors of mid-term recurrence. Conclusion: Both FA and RA annuloplasty are safe and effective techniques for the surgical management of functional TR, demonstrating similar mid-term clinical outcomes and durability.