الفهرس 
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Abstract
Tricuspid valve (TV) diseases are categorized into organic and functional etiologies. Functional or secondary TV regurgitation (TR) occurs in patients with advanced mitral valve disease and pulmonary hypertension.
In patients with longstanding mitral stenosis and pulmonary hypertension, right ventricular dilatation ensues and consequently TV annulus also dilates. This results in failure of proper coaptation of tricuspid leaflets although they are normal in appearance. This results in functional TR (FTR).
Different methods are used for TV repair. The most common are De Vega repair and ring annuloplasty. TV annuloplasty do not consistently eliminate functional regurgitation, and across time regurgitation increases. Different methods of repair have different outcomes both on the short term and the long term. The optimal method for TV repair is still controversial.
The aim of this study is to compare the short term outcomes of De Vega repair versus ring annuloplasty in patients with functional TR.
The study included 60 patients randomized into 2 groups, 30 patients each. Patients from both groups have rheumatic mitral stenosis and severe functional tricuspid regurgitation, and are candidates for mitral valve surgery and tricuspid valve repair. The technique utilized in tricuspid valve repair was ring annuloplasty in group (A), and De Vega repair in group (B).
Patients from both groups underwent mitral valve replacement via conventional full median sternotomy. Mitral valve surgery was done under cardioplegic arrest. Cross clamp was removed and TV repair was done on a beating heart after snaring the SVC and IVC.
Echocardiography was done one week after the operation to assess the success of the repair. Data were recorded and patients were followed up for one year after the operation both clinically and by echocardiography to assess the durability of the repair.
The study concluded that ring annuloplasty provides more effective and more durable reduction of FTR compared to De Vega repair of TV. Mean grade of TR did not increase significantly in the ring annuloplasty group after one year of follow up whereas it increased significantly in the De Vega repair group.