Modified De Vega's Annuloplasty for Functional Tricuspid Regurgitation. Early and Late Results.

Aoyagi, Shigeaki; Tanaka, Ko; Hara, Hiroshi; Kumate, M; Oryoji, Atsushige; Yagi, Hiroshi; Kosuga, K; Ohishi, Kiroku

doi:10.2739/kurumemedj.39.23

Cited by 16 publications

(5 citation statements)

References 16 publications

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“…Tricuspid valve disease occurring with ventricular septal defect was functional and was managed using modified de Vega procedure. 23 Ruptured sinus of Valsalva aneurysm was repaired via aortotomy approach for the aortic valve. The associated ventricular septal defect was also repaired via the left ventricle.…”

Section: Discussionmentioning

confidence: 99%

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Surgical management of CHD in the adult population: the role of humanitarian cardiac surgery mission in Nigeria

Eze

2018

Cardiol Young

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Section: Discussionmentioning

confidence: 99%

“…Mitral valve was replaced with a mechanical valve (St Jude). Tricuspid valve disease occurring with ventricular septal defect was functional and was managed using modified de Vega procedure 23 . Ruptured sinus of Valsalva aneurysm was repaired via aortotomy approach for the aortic valve.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of CHD in the adult population: the role of humanitarian cardiac surgery mission in Nigeria

Eze

2018

Cardiol Young

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“…The modified De Vega annuloplasty technique [2] was used for repair of non-structural tricuspid regurgitation (TR).…”

Section: Methodsmentioning

confidence: 99%

Outcome of left heart mechanical valve replacement in West African children - A 15-year retrospective study

Edwin

Aniteye

Tettey

et al. 2011

J Cardiothorac Surg

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BackgroundThe West African sub-region has poor health infrastructure. Mechanical valve replacement in children from such regions raises important postoperative concerns; among these, valve-related morbidity and complications of lifelong anticoagulation are foremost. Little is known about the long-term outcome of mechanical valve replacement in West Africa. We sought to determine the outcome of mechanical valve replacement of the left heart in children from this sub-region.MethodWe conducted a retrospective review of all consecutive left heart valve replacements in children (< 18 years old) from January 1993 - December 2008. The study end-points were mortality, valve-related morbidity, and reoperation.ResultsOne hundred and fourteen patients underwent mitral valve replacement (MVR), aortic valve replacement (AVR) or mitral and aortic valve replacements (MAVR). Their ages ranged from 6-18 years (13.3 ± 3.1 years). All patients were in NYHA class III or IV. Median follow up was 9.1 years. MVR was performed in 91 (79.8%) patients, AVR in 13 (11.4%) and MAVR in 10 (8.8%) patients. Tricuspid valve repair was performed concomitantly in 45 (39.5%) patients.There were 6 (5.3%) early deaths and 6 (5.3%) late deaths. Preoperative left ventricular dysfunction (ejection fraction < 45%) was the most important factor contributing to both early and late mortality. Actuarial survival at 1 and 15 years were 98.1% and 94.0% respectively. Prosthetic valve thrombosis occurred in 5 patients at 0.56% per patient-year. There was 1(0.9%) each of major bleeding event and prosthetic valve endocarditis. Two reoperations were performed at 0.22% per patient-year. Actuarial freedom from reoperation was 99.1% at 1 and 10 years, and 85.1% at 15 years.ConclusionMechanical valve replacement in West African children has excellent outcomes in terms of mortality, valve-related events, and reoperation rate. Preoperative left ventricular dysfunction is the primary determinant of mortality within the first 2 years of valve replacement. The risk of valve-related complications is acceptably low. Anticoagulation is well tolerated with a very low risk of bleeding even in this socioeconomic setting.

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“…9,15 It has long been recognized that ring annuloplasty is unlikely to successfully treat severe leaflet tethering resulting in TR; several repair techniques have been suggested for these cases, including suture bicuspidization of the TV, and the clover technique. 16,17 Aoyagi and colleagues 18 reported a TR recurrence rate of 11.6%, a 10-year survival rate of 88.2%, and a freedomfrom-reoperation rate of 97.6% after modified De Vega annuloplasty. However, when functional TR results from both severe annular dilation and leaf let tethering, annuloplasty alone is unlikely to be successful.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Artificial Neochordae Implantation in Tricuspid Valve Repair

Salihi¹,

Kızıltan²,

Huraibat³

et al. 2019

Texas Heart Institute Journal

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Various techniques for treating tricuspid regurgitation have been described; however, because of scarce data about the long-term outcomes of different repairs, the optimal technique has not been established. We evaluated the effectiveness and durability of artificial neochordae implantation in the treatment of tricuspid regurgitation.From 2009 through 2014, 507 patients underwent tricuspid valve repair at our institution. Of those, 48 patients implanted with artificial neochordae were included in our study. The median age of the participants was 62 years (range, 4-77 yr) and 50% were women. Thirty patients (63%) were in New York Heart Association functional class III, and 11 (23%) were in class II. The cause of tricuspid regurgitation was functional in 33 patients (69%) and rheumatic in 15 (31%). In 46 patients, neochordae implantation was performed in addition to Kay annuloplasty (n=13) or ring annuloplasty (n=33).Forty-two patients were discharged from the hospital with absent or mild tricuspid regurgitation. The mean follow-up period was 44.3 ± 20.2 months. Follow-up echocardiograms revealed that tricuspid regurgitation was absent, minimal, or mild in 38 patients (80.8%), moderate in 7, and severe in 2.Our results indicate that the use of artificial neochordae implantation as an adjunct procedure to annuloplasty leads to effective and durable repair in comparison with conventional techniques for treating tricuspid regurgitation. (Tex Heart Inst J 2019;46(2):100-6)

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Modified De Vega's Annuloplasty for Functional Tricuspid Regurgitation. Early and Late Results.

Cited by 16 publications

References 16 publications

Surgical management of CHD in the adult population: the role of humanitarian cardiac surgery mission in Nigeria

Surgical management of CHD in the adult population: the role of humanitarian cardiac surgery mission in Nigeria

Outcome of left heart mechanical valve replacement in West African children - A 15-year retrospective study

Effectiveness of Artificial Neochordae Implantation in Tricuspid Valve Repair

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