Surgical management of tricuspid regurgitation associated with acquired valvular disease

The best means of managing tricuspid regurgitation associated with acquired valvular disease is still controversial. During the period from 1978 to 1988, 111 patients who had tricuspid regurgitation along with associated valvular dysfunction were treated in Kagoshima University Hospital. Patients with moderate to severe regurgitation underwent annuloplasty in 61 (Carpentier's in 39, DeVega's in 20, and Kay's method in 2) and valve replacement in 8. Forty-two patients were treated conservatively on the tricuspid valve because of mild regurgitation. We found the results to be less satisfactory with a high incidence of postoperative deaths and residual tricuspid regurgatation in the group treated by annuloplasty with a Carpentier ring than in the other two groups of annuloplasty or in the group of valve replacement. We conclude the modified DeVega's method is the first choice for annuloplasty in patients with mild to moderate regurgitation, and we believe it appropriate to replace the valve in an increasing number of subjects which have severe regurgitation.