New developments for reconstruction of the tricuspid valve

Minale, C; Lambertz, Heinz; Messmer, Bruno J.

doi:10.1016/s0022-5223(19)36228-2

Cited by 15 publications

(5 citation statements)

References 7 publications

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“…Management options for functional TR include conservative treatment, repair and replacement. Conservative management of TR is justified in mild TR provided that the annulus and valvular structure are within normal [9]. Reluctance to interfere was previously based on a concept that functional TR will improve after dealing with mitral valve pathology and pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

Pericardial Strip versus Ring Annuloplasty for Repair of Functional Tricuspid Regurgitation

Jabbad¹,

Elassal²,

Eldib³

2014

WJCS

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Background: Functional tricuspid regurgitation is a challenge regarding indications for repair and proper surgical technique. Aim of the study: We reviewed our midterm results of tricuspid valve repair for functional regurgitation comparing pericardial strip versus ring annuloplasties. Patients and methods: From January 2008 to December 2013, we operated 59 patients (male:female, 41:18, with a mean age of 34 ± 14 years) for functional tricuspid regurgitation. Tricuspid annuloplasty was done using pericardial strip in 39 patients and ring in 20 patients. Concomitant procedures were mitral valve replacement in 66% of patients, aortic valve replacement in 5% and double valve replacement in 29%. Clinical and echocardiographic data were collected. Results: Preoperative characteristics of the two groups were similar regarding age, percentage of female patients, New York Heart Association functional class and pulmonary artery pressure. More patients with preoperative right ventricular dysfunction were found in pericardial annuloplasty group although this was not statistically significant (13 versus 5; P = 0.52). Operative times were similar in both groups. We had one mortality case (1.69%) due to low cardiac output in the pericardial group. Postoperative complications included reexploration for bleeding in one patient and chronic heart failure in another patient. The average follow up period was 3 years and it was complete in 100% of patients. Postoperative freedom from recurrent moderate tricuspid regurgitation was 90% in both groups. Conclusion: Pericardial strip annuloplasty is a simple, inexpensive, reproducible and efficient technique that has comparable results to ring annuloplasty.

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Section: Discussionmentioning

confidence: 99%

Pericardial Strip versus Ring Annuloplasty for Repair of Functional Tricuspid Regurgitation

Jabbad¹,

Elassal²,

Eldib³

2014

WJCS

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“…Aufgrund der besseren Langzeitergebnisse [8,9] wird heutzutage in vielen Zentren die Rekonstruktion mit Implantat bevorzugt.…”

Section: Introductionunclassified

“…Auch ein seltener Ersatz der Trikuspidalklappe ist vor allem bei ausgesprochen dilatiertem Anulus oder zerstörten Segeln mittels prothetischer Herzklappe möglich [12]. Trotz allgemeiner Bevorzugung von Bioprothesen finden sich im Langzeitverlauf keine Unterschiede zwischen Patienten mit mechanischer oder biologischer Trikuspidalklappenprothese, was Überleben oder unerwünschte Ereignisse angeht [8,13].…”

Section: Introductionunclassified

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Operative und interventionelle Therapie der Trikuspidalklappe – neue Entwicklungen

et al. 2017

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ZusammenfassungDie symptomatische hochgradige Trikuspidalklappeninsuffizienz hat eine hohe Mortalität und tritt häufig in Kombination mit linksseitigen Herzklappenerkrankungen auf. Die Behandlung der Trikuspidalklappeninsuffizienz erfordert eine genaue anatomische Kenntnis des Trikuspidalklappenapparats und für die Planung einer operativen oder interventionellen Behandlung ist eine genaue Evaluation der zugrunde liegenden Ätiologie unabdingbar. Minimalinvasive Behandlungsoptionen sind im Moment fast ausschließlich im Rahmen von Studien möglich. Erste klinische und prozedurale Erfahrungen mit den neuen Techniken sind vielversprechend. In diesem Übersichtsartikel werden die einzelnen Techniken und Optionen zusammengefasst.

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“…The use of repair techniques for moderate (posterior annuloplasty) or severe (Carpenter-Edwards tricuspid annuloplasty ring) TR will be satisfactory for virtually all patients with this lesion. (J Card Surg 1994; 9[Suppl):237-24 7) In North American patients, tricuspid regurgitation (TR) is usually secondary to pulmonary hypertension and concomitant mitral valve disease. Surgical treatment of functional TR has often been an enigma to cardiac surgeons.…”

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confidence: 99%

Tricuspid Regurgitation Secondary to Mitral Valve Disease: When and How to Repair

Cohn

1994

J Cardiac Surgery

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The etiology of tricuspid regurgitation (TR) in North American patients with mitral valve disease is almost entirely nonrheumatic functional dilatation of the tricuspid annulus. In mild TR, no operative therapy is necessary since relief of the left sided valve lesion will suffice to bring the pulmonary pressure down and, consequently, relief of TR for moderate (2+ to 3+) TR. We have used a technique of posterior annuloplasty using a DeVega type double running braided suture beginning at the commissure of the anterior and posterior leaflets and running to the commissure between the septal and posterior leaflets, and tied over an obturator. The technique takes less than 10 minutes. Seventy-one patients in the past 10 years have been treated with this technique with virtually 100% relief of TR. For severe TR, we advocate the use of Carpentier-Edwards annuloplasty ring with interrupted sutures (16 patients). We believe severe TR requires a fixed annulus for virtually the entire circumference of the valve. Functionally regurgitant tricuspid valves should be reconstructed and not replaced. The use of repair techniques for moderate (posterior annuloplasty) or severe (Carpenter-Edwards tricuspid annuloplasty ring) TR will be satisfactory for virtually all patients with this lesion.

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New developments for reconstruction of the tricuspid valve

Cited by 15 publications

References 7 publications

Pericardial Strip versus Ring Annuloplasty for Repair of Functional Tricuspid Regurgitation

Pericardial Strip versus Ring Annuloplasty for Repair of Functional Tricuspid Regurgitation

Operative und interventionelle Therapie der Trikuspidalklappe – neue Entwicklungen

Tricuspid Regurgitation Secondary to Mitral Valve Disease: When and How to Repair

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