Isolated tricuspid valve surgery in patients with previous cardiac surgery

Pfannmüller, Bettina; Moz, Monica; Misfeld, Martín; Borger, Michael A.; Funkat, Anne-Kathrin; Garbade, Jens; Mohr, Friedrich W.

doi:10.1016/j.jtcvs.2012.07.096

Cited by 72 publications

(58 citation statements)

References 11 publications

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“…While our 17.6% rate of residual TV regurgitation in the replacement group is relatively high, it is within range of the few studies in the literature that report this information. Buzzatti et al and Pfannmuller et al reported residual TV regurgitation in 13.9% and 17% respectively after TV replacement (3,6). The reasons for this are unclear and could be due to failure or improper remodeling of the RV geometry after TV replacement.…”

Section: Comparison Of Outcomesmentioning

confidence: 98%

“…This is especially true in the setting of right ventricular failure (4). While some studies have questioned if TV replacement is ever indicated (5), there is increasing interest in TV pathology and interventions reflected in recent publications (1,(6)(7)(8). We present our mid and long term outcomes with ITV surgery to help elucidate the indications, timing, and surgical approach for ITV repair and/or replacement.…”

Section: Introductionmentioning

confidence: 99%

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Surgical outcomes of isolated tricuspid valve procedures: repair versus replacement

Ejiofor

Neely

Yammine

et al. 2017

Ann. Cardiothorac. Surg.

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Background: Isolated tricuspid valve (ITV) operations are infrequent and the decision to operate is controversial. We report a series of ITV operations to outline the current disease status requiring this uncommon procedure with an emphasis on the results of tricuspid valve repair (TVr) versus replacement (TVR).Methods: Using our prospective cardiac surgery database, 57 patients who underwent ITV operations between 01/02-03/14 were identified. Median follow up time was 3.5 years [interquartile range (IQR), 0.8-6.7 years].Results: Fifty-seven patients underwent ITV surgery with a mean age of 54.4±14.9 yrs and 61% were women. Baseline characteristics were similar between patients who underwent TVr (n=18) or TVR (n=39).The etiologies of TV dysfunction were: ITV endocarditis 14/57 (25%), persistent TV regurgitation after left-sided valve surgery in 12/57 (21%), traumatic biopsies and iatrogenic injury from pacing leads in 11/57 (19%), orthotopic heart transplant 9/57 (16%), carcinoid syndrome 3/57 (5%), congenital 2/57 (5%) and idiopathic 5/57 (9%). Overall, 32/57 (56%) patients had prior heart surgery; of which 10/32 (31%) were TV procedures. Bioprosthetic prostheses were used in 34/39 (87%) patients. Of those who had repair, 11/18 (61%) had ring annuloplasty, 3/18 (17%) bicuspidization, and 3/18 (17%) De Vega annuloplasty and one had vegetectomy. Operative mortality was 5.1% (n=2) and 16.7% (n=3) for TVR and TVr groups, respectively (P=0.32), with an overall mortality rate of 8.6%. Postoperative complications included new onset renal failure in 6/39 (15%) of TVr and 2/18 (11%) of TVR (P=0.71) and there were no strokes. Overall survival rates and degree of residual RV dysfunction were similar for the two groups (both P=0.3). Five-year survival was 77% and 84% for TVr and TVR respectively (P=0.52). There was no difference in rates of recurrent tricuspid regurgitation for TVr and TVR (35.7% vs. 23.5%, respectively, P=0.4).Conclusions: ITV surgery is associated with improved but still relatively high operative mortality. Midterm outcomes for TVr and TVR are similar with regards to postoperative complications, survival, and freedom from recurrent tricuspid regurgitation.

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Section: Comparison Of Outcomesmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of isolated tricuspid valve procedures: repair versus replacement

Ejiofor

Neely

Yammine

et al. 2017

Ann. Cardiothorac. Surg.

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“…The increased risk is usually due to the fact that pa tients who undergo surgeries are always late in the disease process and often have additional complications associated with right heart failure. So far, infrequent articles regarding pa tient outcomes following a TV reoperation have been published and they usually reviewed (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Benefits of a right anterolateral minithoracotomy rather than a median sternotomy in isolated tricuspid redo procedures

et al. 2017

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Background:To compare results of tricuspid valve (TV) reoperation between incision via a right anterolateral minithoracotomy (RAMT) and median sternotomy (MS). Methods:We performed a retrospective analysis of 49 patients who underwent isolated TV surgery as a reoperation at our institution between 2006 and 2015. Previous cardiac operations included mitral, aortic, and TV surgeries, atrial septal defect repair, and pericardiectomy. The mean age of the patients was 51.9±12.8 years, 14 (28%) were male and 35 (72%) were female. Follow-up was 95% (38/40) complete, with a mean duration of 41.3±19.5 months.Results: Perioperative demographic and laboratory tests did not show any significant differences between the RAMT and MS groups. The drainage volume, total red cell unit, total serum volume and platelet were significantly different 1150±803.5/2,270±1,920, 4.8±4.1/8.7±8.9, 478.2±488.9/950.0±857.6, 0.04±0.21/0.38±0.64 (P<0.05), while other perioperative data were similar. There were no significant differences in early postoperative death and complications between the RAMT and MS groups.A multivariate linear regression analysis predicted that serum creatinine (Scr), age, and MS group were independent risk factors for bleeding. The Cox regression demonstrated that the MS group had a longer drainage duration (P<0.05) and had a relative hazardous risk (HR) of 2.691 (1.328, 5.450 CI) compared with the RAMT group. Conclusions:The RAMT approach is an alternative, safe, and feasible procedure for isolated TV reoperation. It has the advantages of less drainage and reduced requirement for blood products.

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“…Isolated tricuspid valve repair has been associated with mortality rates of 8.2-9.5% (6,7). Mortality rates with re-operative isolated tricuspid valve surgery have ranged from 13.2-37% (8)(9)(10). Approximately half of all patients undergoing isolated tricuspid surgery have a history of prior cardiac surgery.…”

Section: Clinical Resultsmentioning

confidence: 99%

Minimal access tricuspid valve surgery

Lamelas¹

2017

ASVIDE

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Isolated tricuspid valve surgery in patients with previous cardiac surgery

Cited by 72 publications

References 11 publications

Surgical outcomes of isolated tricuspid valve procedures: repair versus replacement

Surgical outcomes of isolated tricuspid valve procedures: repair versus replacement

Benefits of a right anterolateral minithoracotomy rather than a median sternotomy in isolated tricuspid redo procedures

Minimal access tricuspid valve surgery

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