Al-kasr al-ainy experience in management of functional tricuspid valve disease / Ahmed Yacoub Mohamed Adas ; Supervised Yahia Balbaa Anwar Balbaa , Ahmed Maher Elnaggar , Ahmed Mohamed Fathy Alashkar

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Functional tricuspid regurgitation (FTR) is frequently present in patients undergoing left side valve surgery. Untreated FTR may lead to right heart failure. Appropriate treatment can improve long-term outcome. Reoperative cardiac surgery for late FTR is associated with high morbidity and mortality. Objectives: The aim of this work is to collect, review and analyze data of patients with any degree of functional Tricuspid valve disease necessitating surgery and to evaluate the different surgical strategies that can affect the outcome of intervention in these patients. Methods: A comparative analytical study including200 patients with functional TVD. Patients will be categorized according to the type of technique of management functional TVD. In to 3 groups: ring group, suture group and band group. Safety and efficacy of different TVD management procedures will be evaluated throughout the study. Results: show that the 3 groups had improvement in LV and RV function, Vena contracta, Pulmonary Artery Pressure, NYHA class and mean degree of TR and low complication and recurrence rates. However, patients in Ring Group had significantly better results and lower recurrence rates than other 2 Groups. 5patients died in early post op period. There was no need for reoperation or hospital readmission for right-sided heart failure for tricuspid regurgitation in both groups by the end of first year postoperatively. Conclusion: tricuspid valve is better to be repaired by ring annuloplasty. If not avalible, Repair of functional TR by a piece of PTFE tube graft is a simple, safe, cheap and effective way to manage moderate-to-severe and severe incompetence

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