Abstract
ObjectivesLong-term data on isolated surgical tricuspid valve procedures is limited. Current guidelines on heart valve disease recommend valve repair over valve replacement. In this study we report our 12-year single-center experience with isolated surgical tricuspid valve repair in patients with various tricuspid valve pathologies.MethodsBetween May 2007 and December 2019, 26 consecutive patients underwent isolated tricuspid valve annuloplasty/repair for various indications. In 18 patients (69.2%) an open ring or band annuloplasty (26.9 and 42.3%, respectively) was performed, 5 patients (19.2%) underwent a tightening of the annulus using the DeVega technique, 5 patients (19.2%) had a leaflet reconstruction with patch or bicuspidalization and in 3 patients (11.5%) a leaflet debridement was performed. In 15.4% of the cohort a combination of the techniques was utilized.ResultsThe mean follow-up time was 2.1 (0.3–5.0) years. Early survival at 30 days after surgery was 84.6%. Mean hospital stay was 11 (6.7–16) days. One-year survival was 73%. No patient required a redo procedure on the tricuspid valve during follow-up.ConclusionTricuspid valve repair is suggested as a treatment of choice according to recent guidelines on heart valve disease. If chosen correctly, various repair techniques provide good long-term results. Tricuspid valve repair may be safely applied in patients undergoing surgical isolated tricuspid valve procedures.
Highlights
Tricuspid regurgitation (TR) often has a secondary nature, resulting from volume or pressure overload in the presence of right ventricular (RV) failure and annular dilatation with structurally normal leaflets [1]
Valve repair should be preferred over valve replacement for secondary TR, based on the surgeon’s experience, specifics of the valve pathology, and the patient’s condition
Twenty-one (80.8%) patients presented with severe TR, 42.3% (n = 11) suffered from pulmonary hypertension, and 26.9% (n = 7) presented with at least mild impairment of the right ventricular function as determined by transthoracic or transesophageal echocardiography
Summary
Tricuspid regurgitation (TR) often has a secondary nature, resulting from volume or pressure overload in the presence of right ventricular (RV) failure and annular dilatation with structurally normal leaflets [1]. Indication and Current guidelines suggest that surgery should be carried out as early as onset of signs of RV dysfunction [2]. Valve repair should be preferred over valve replacement for secondary TR, based on the surgeon’s experience, specifics of the valve pathology, and the patient’s condition. Valve replacement should be restricted to those pathologies with severely destroyed and tethered leaflets and to cases with a severe annular dilatation [2]. Most of the current data on surgical therapy of severe TR originate from concomitant procedures on the left
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
