Partial Annular Plication for Atrioventricular Valve Regurgitation

Various annuloplasty techniques are used to correct tricuspid or mitral valve regurgitation. We performed a partial annular plication procedure, a modification of the annuloplasty introduced by Davila, in 23 consecutive patients with moderate to severe tricuspid regurgitation or moderate mitral regurgitation. A slender plastic tube was used to tighten snugly the suture during intraoperative saline flushing test for assessment of the valve competency. This technique enabled us to add one stitch or two for more plication before the suture was tied if necessary. During a mean follow-up period of 13.8 months postoperatively, 10 patients (43.5%) had no valve regurgitation, 12 patients (52.2%) had grade 1+ regurgitation, and 1 patient (4.3%) grade 2+ on color Doppler echocardiography. The regurgitation grade remained unchanged or improved after the initial postoperative study. Our surgical experience indicates that the adjustable procedure of partial annular plication is a simple, exact, and durable procedure in patients of all ages with moderate to severe functional atrioventricular regurgitation.