Beating Heart Versus Arrested Heart Isolated Tricuspid Valve Surgery

Abstract

We analyzed the long-term results of two surgical techniques (beating versus non-beating) for isolated tricuspid valve (TV) surgery.The long-term results of 92 consecutive patients who underwent isolated TV surgery were analyzed. We compared patients with beating heart (BH) surgery (n = 48) with patients undergoing arrested heart (AH) surgery (n = 44).BH surgery was more frequently chosen in urgent/emergent operations (P = 0.029) and in redo-operations (P < 0.001). Preoperatively, the rates of renal insufficiency (P = 0.002) and EuroSCORE (P = 0.019) were higher in the BH group than in the AH group. There were no differences in perioperative outcomes and 30-day mortality between the groups. However, freedom from reoperation was significantly lower in the BH group compared to the AH group (P = 0.039). We observed a trend towards lower survival rates at 1, 5, and 10 years in the BH group (77%, 54%, and 41%) compared to those of the AH group (86%, 75%, and 72%, P = 0.062). Multivariate Cox hazard model analysis revealed preoperative heart rhythm (P = 0.014, odds ratio [OR] = 2.296) and EuroSCORE (P = 0.022, OR = 1.049) as independent risk factors for mortality after isolated TV surgery.The superiority of BH surgery over AG surgery was not proven. Surgical intervention should be considered early, since patients with elevated EuroSCORES and arrhythmia have significantly higher mortality rates.

Comparison of aortic cross-clamping versus beating heart surgery in tricuspid valve repair

“…Therefore, it is particularly recommended that TVR can be performed on a BH for functional TR cases. [23][24][25] Our study also confirms that the prevalence of early and late TR in the ACC group is higher, indicating a statistically significant difference. At early echocardiographic assessment after discharge, >2 TR was more common in the ACC group (n=15, 16%) than the BH group (n=3, 3%).…”

Minimal invasive beating heart tricuspid valve repair in the presence of a severely calcified ascending aorta

“…Previous studies showed no significant differences in the perioperative outcome and 30-day mortality if we compare beating heart to arrested heart tricuspid valve surgery [3]. Even though in general beating heart surgery showed no superiority over arrested heart surgery, it is the better choice in the presence of severe ascending aortic atherosclerosis.…”

Single Femoral Venous Drainage Versus Both Vena Cava Drainage in Isolated Repeat Tricuspid Valve Surgery

“…As for the FV group, there was only one femoral venous cannula used for venous drainage during the CPB. During the operation, the vena cava did not need to be snared when the heart was beating; [7][8][9] in other words, there was no need to dissect the adhesion tissue of the vena cava, which would have increased the operative risk. 5,10) The application of a single venous drainage technique should satisfy the following requirements: (1) there are enough pores in the femoral vein cannula; (2) VAVD controller must be applied; and (3) the top of the femoral vein cannula must reach the SCV.…”