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The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 196-203, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
R Rivera, E Duran and M Ajuria
To compare the efficacy of Carpentier's tricuspid annuloplasty with De
Vega's, we prospectively randomized 159 patients, operated upon between
January, 1977, and January, 1980, to one of the two techniques: 76 patients
were assigned to the Carpentier group and 83 to the De Vega group. The
criterion for inclusion in the study was the presence of moderate to severe
tricuspid regurgitation. There were no significant differences in mean age,
male proportion, type of mitral lesion, incidence of aortic valvulopathy,
and other preoperative and perioperative characteristics between the two
groups. However, organic tricuspid damage on macroscopic intraoperative
examination was more common in the Carpentier group. At the end of
follow-up (average 64 months) in patients with satisfactory left heart
hemodynamics, there was a significant difference in the incidence of
moderate or severe tricuspid insufficiency between the two groups (De Vega,
14/41; Carpentier, 4/40; p less than 0.01). In 76 patients (40 with
Carpentier's annuloplasty and 36 with De Vega's technique), contrast right
ventriculography was performed postoperatively and the degree of tricuspid
regurgitation assessed semiquantitatively. In both groups, control of
tricuspid regurgitation was poor in patients with either high total
pulmonary resistances or organic tricuspid damage. If patients with these
characteristics are excluded, then significant tricuspid regurgitation was
encountered in only one patient in the Carpentier group but in nine of 19
in the De Vega group (p less than 0.01). In conclusion, in the treatment of
tricuspid regurgitation, better results are obtained with Carpentier's than
with De Vega's annuloplasty, especially if there is no organic tricuspid
damage and pulmonary resistances decrease postoperatively.
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Carpentier's flexible ring versus De Vega's annuloplasty. A prospective randomized study
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