Tricuspid annuloplasty significantly reduces early tricuspid regurgitation after biatrial heart transplantation

Prevalence and Risk Factors for Tricuspid Valve Regurgitation After Pediatric Heart Transplantation

“…11 Prophylactic annuloplasty performed with a biatrial anastomosis has been shown to reduce early post-operative TR in a small study. 24 A recent randomized trial demonstrated that a standard bicaval technique combined with prophylactic tricuspid annuloplasty resulted in reduced peri-operative mortality, improved right ventricular performance, and a reduction in TR at 1-year follow-up, when compared with bicaval anastomosis alone. 12 Prophylactic annuloplasty has not been shown to confer an advantage in the pediatric OHT population; however, this technique has been demonstrated to be successful in patients with congenital heart disease.…”

Tricuspid Valve Replacement After Cardiac Transplantation

“…Modification of an orthotopic heart transplantation procedure was reported by adding tricuspid annuloplasty to bi-atrial anastomoses 40 and bi-caval anastomoses, 41 which showed a reduction in early tricuspid regurgitation 40 and also late tricuspid regurgitation up to 1 year. 41 Modification of the endomycardial biopsy procedure was suggested either by the use of echocardiography, 42 which could be limited in some cases by the viewing windows, the use of a special long sheath that passes the tricuspid valve 3 to minimize the risk of valve damage, or even by limiting the number of endomyocardial biopsies after heart transplant for asymptomatic patients who have no significant history of rejections.…”

Tricuspid Valve Regurgitation after Orthotopic Heart Transplantation: Prevalence and Etiology

“…The etiology of TR after OHT is unclear, and several variables have been reported to be related, including the surgical anastomosis technique employed (biatrial versus bicaval) [8–13], iatrogenic damage due to endomyocardial biopsies (EMBs) [8, 14–18], number of acute cellular rejection episodes (ACRs) [8, 14], pretransplant pulmonary hypertension [8, 19, 20], discordance between the size of the donor's heart and the recipient's pericardial cavity [21], and cardiac allograft vasculopathy (CAV) [14]. Preventive measures mentioned in the literature include prophylactic tricuspid annuloplasty during OHT [22–24], the use of a long bioptome sheath during EMB [18], and the use of noninvasive methods to monitor for graft rejections [25]. …”