Abstract
BackgroundRedo isolated tricuspid valve surgery is associated with a high morbidity and mortality, and its optimal timing remains controversial. Hence, here we reviewed the early and midterm results of simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery in patients at high risk.MethodsA total of 32 consecutive patients underwent a redo isolated tricuspid valve surgery using minimally invasive, beating-heart technique through a right lateral thoracotomy in our center between June 2016 and April 2020. The mean age of patients was 57.4 ± 8.3 years, and 18 patients (56.3%) were women. The mean preoperative EuroSCORE was 7.8 ± 1.4 (range: 6–11). Follow-up was 87.1% complete, with a mean duration of 26.3 ± 12.3 months.ResultsBoth in-hospital and 30-day mortalities were 3.1%. Tricuspid valve replacement with bioprosthesis was performed in 30 patients (93.8%), and the remaining two patients (6.2%) underwent tricuspid repair (annuloplasty and leaflet reconstruction). The mean cardiopulmonary bypass time was 81.5 ± 29.0 min. The overall in-hospital duration and intensive care unit (ICU) times were 13.6 ± 7.6 days and 4.1 ± 2.8 days, respectively. Postoperative complications included prolonged ventilation in six patients (18.8%), acute kidney injury in three patients (9.4%), and neurologic event, wound infection, or permanent third-degree atrioventricular block, in one patient (3.1%) each. A total of 96.9% patients were discharged uneventfully. Four patients were lost to follow-up; there were no midterm deaths in patients who were followed up.ConclusionsSimplified, minimally invasive, beating-heart technique for redo tricuspid valve surgery is both feasible and safe, and the early and midterm results are excellent.
Highlights
Tricuspid valve disease has always been considered less clinically important than mitral and aortic valve pathology, and its optimal timing for surgical intervention remains controversial [1]
Lu et al Journal of Cardiothoracic Surgery (2020) 15:146 until right heart failure, uncontrolled ascites, or edema of lower extremities develop [3, 4]. In this context, isolated tricuspid valve surgery is often associated with a high morbidity and mortality [5,6,7]
Left ventricular ejection fraction (EF) of patients was almost normal in 58.3 ± 7.1%
Summary
Tricuspid valve disease has always been considered less clinically important than mitral and aortic valve pathology, and its optimal timing for surgical intervention remains controversial [1]. Lu et al Journal of Cardiothoracic Surgery (2020) 15:146 until right heart failure, uncontrolled ascites, or edema of lower extremities develop [3, 4]. In this context, isolated tricuspid valve surgery is often associated with a high morbidity and mortality [5,6,7]. Redo isolated tricuspid valve surgery is associated with a high morbidity and mortality, and its optimal timing remains controversial. Here we reviewed the early and midterm results of simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery in patients at high risk
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