[Preoperative diagnosis and surgical treatment of tricuspid regurgitation (TR) in patients with acquired valvular heart disease--comparison of Kay's annuloplasty and Carpentier's ring annuloplasty for tricuspid valve surgery].

The purpose of this study is to compare the results of TR repair by using doppler echocardiography. 52 patients who underwent tricuspid repair surgery from 1980 to 1987 were studied. 30 patients received Kay's annuloplasty (K-A group) while 16 patients were repaired with Carpentier's ring annuloplasty (C-E group). A new classification of TRs according to the direction and the area of the regurgitant flow on doppler echocardiogram was applied to the preoperative TRs. In addition to grading the severity of the regurgitations on a four-point scale, the TRs were subdivided into three types according to the direction of the regurgitant flow toward, the interatrial septum (type a), the center of the atrium (type b), and the lateral side of the right atrium (type c). Regurgitation covering more than two of the three areas was recognized as massive TR. In the K-A group, 5 cases showed massive TR and 11 cases showed localized TR preoperatively. Localized TR cases were well controlled in all cases but 4 out of 5 massive TR cases remained third grade and type b postoperatively. In the C-E group, 9 cases showed massive TR and 7 cases showed localized TR. All cases were displayed good control of the regurgitation postoperatively. Postoperative pressure half time of the tricuspid valve orifice treated with the two types of annuloplasty were 108 +/- 25 msec in the C-E group versus 151 +/- 43 msec in the K-A group (p less than 0.001), which indicates the tendency of the K-A group to produce narrowed tricuspid orifice.(ABSTRACT TRUNCATED AT 250 WORDS)