Rationale and Initial Experience With the Tri-Ad Adams Tricuspid Annuloplasty Ring
Federico Milla, MD, Javier G. Castillo, MD, Robin Varghese, MD, Joanna Chikwe, MD, Anelechi C. Anyanwu, MD, and David H. Adams, MD
Controversy exists regarding the indication and method of repair of functional tricuspid regurgitation (TR) in patients undergoing mitral valve surgery. Whereas the American College of Cardiology/American Heart Association guidelines recommend tricuspid repair in the setting of severe TR, tricuspid repair is advised for less than severe TR in the setting of annular dilation or pulmonary hypertension. Although multiple repair strategies exist, the use of a ring annuloplasty (semirigid remodeling rings vs flexible bands) is the preferred method of therapy to avoid short- and long-term recurrence of TR. The new Tri-Ad Adams annuloplasty ring combines elements of semirigid and flexible bands that will not only allow for annular remodeling in the region of the right ventricular free wall but also potentially reduce injury to the conduction system with its flexible and "open" ends. In this article, we discuss the rational for an aggressive approach to functional tricuspid regurgitation, and show our initial clinical experience with the Tri-Ad Adams annuloplasty ring.
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Publications
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Transcatheter Repair for Patients with Tricuspid Regurgitation
Paul Sorajja, MD, Brian Whisenant, MD, David H. Adams, MD, et al. -
Failure to Rescue: A Quality Metric for Cardiac Surgery and Cardiovascular Critical Care
Caroline R Gross, David H Adams, Parth Patel, Robin Varghese -
Research Opportunities in the Treatment of Mitral Valve Prolapse: JACC Expert Panel
Francesca N Delling, Peter A Noseworthy, David H Adams, et al. -
Plasma Renin Activity Increases With Cardiopulmonary Bypass and is Associated With Vasoplegia After Cardiac Surgery
Morgan L Montgomery, Caroline R Gross, Hung-Mo Lin, Yuxia Ouyang, Matthew A Levin, Holly E Corkill, Ahmed El-Eshmawi, David H Adams, Menachem M Weiner