Commentary: Late tricuspid valve insufficiency following mitral valve repair: A marker or a cause for inferior outcome?

Abstract Background The timing for heart surgery following cerebral embolization after cardiac valve vegetation is vital to postoperative recovery being uneventful, additionally Covid-19 may negatively affect the outcome. Minimally invasive methods and upgraded surgical instruments maximize the benefits of surgery also in complex cardiac revision cases with substantial perioperative risk. Case presentation A 68 y.o. patient, 10 years after previous sternotomy for OPCAB was referred to cardiac surgery on the 10th postoperative day after neurosurgical intervention for intracerebral bleeding with suspected mitral valve endocarditis. Mitral valve vegetation, tricuspid valve insufficiency and coronary stenosis were diagnosed and treated by minimally invasive revision cardiac surgery on the 14th postoperative day after neurosurgery. Conclusion The present clinical case demonstrates for the first time that the minimally invasive approach via right anterior mini-thoracotomy can be safely used for concomitant complex mitral valve reconstruction, tricuspid valve repair and aorto-coronary bypass surgery, even as a revision procedure in the presence of florid endocarditis after recent neurosurgical intervention. The Covid-19 pandemic and prophylactic patient isolation slow down the efficacy of pulmonary weaning and mobilisation and prolong the need for ICU treatment, without adversely affecting long-term outcome.

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Tricuspid valve repair via partial sternotomy for traumatic valve insufficiency

Asian Cardiovascular and Thoracic Annals ◽

10.1177/02184923211010080 ◽

2021 ◽

pp. 021849232110100

Author(s):

Motohiro Maeda ◽

Jiro Honda ◽

Yosuke Ishi

Keyword(s):

Tricuspid Valve ◽

Chest Trauma ◽

Right Heart Failure ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Cardiac Trauma ◽

Partial Sternotomy ◽

Tricuspid Valve Insufficiency ◽

Valve Insufficiency ◽

Early Surgical Intervention

Tricuspid valve insufficiency rarely follows a blunt chest trauma. When the tricuspid valve is solely injured, the cardiac trauma may stay asymptomatic and tolerable, which often makes it difficult to determine the indication for surgery. We report a case of a patient with tricuspid regurgitation secondary to trauma due to a motorcycle accident. The patient was initially asymptomatic, but shortness of breath emerged two years after the accident. He underwent the tricuspid valve repair with chordae reconstruction and annuloplasty via lower partial sternotomy. We advocate that early surgical intervention prevents right heart failure, atrial fibrillation, and valve replacement.

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Mitral valve disease associated with tricuspid valve insufficiency. Post-operative clinical and hemodynamic study.

Japanese Journal of Cardiovascular Surgery ◽

10.4326/jjcvs.14.389 ◽

1985 ◽

Vol 14 (6) ◽

pp. 389-391

Author(s):

Y. Kumiyoshi

Keyword(s):

Mitral Valve ◽

Tricuspid Valve ◽

Mitral Valve Disease ◽

Valve Disease ◽

Tricuspid Valve Insufficiency ◽

Valve Insufficiency ◽

Hemodynamic Study

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Video-assisted minimal access surgery for complicated mitral valve endocarditis, tricuspid valve insufficiency and progressive coronary disease after previous CABG - in the time of COVID-19: a case report

10.21203/rs.3.rs-340141/v1 ◽

2021 ◽

Author(s):

Terezia B. Andrasi ◽

Nunijiati Abudureheman ◽

Alannah Glück ◽

Maximillian Vondran ◽

Ildar Talipov ◽

...

Keyword(s):

Cardiac Surgery ◽

Mitral Valve ◽

Minimally Invasive ◽

Tricuspid Valve ◽

Surgical Instruments ◽

Tricuspid Valve Repair ◽

Long Term Outcome ◽

Tricuspid Valve Insufficiency ◽

Valve Insufficiency ◽

Neurosurgical Intervention

Abstract Background: The timing for heart surgery following cerebral embolization after cardiac valve vegetation is vital to postoperative recovery being uneventful, additionally Covid-19 may negatively affect the outcome. Minimally invasive methods and upgraded surgical instruments maximize the benefits of surgery also in complex cardiac revision cases with substantial perioperative risk. Case Presentation: A 68 y.o. patient, 10 years after previous sternotomy for OPCAB was referred to cardiac surgery on the 10th postoperative day after neurosurgical intervention with suspected mitral valve endocarditis. Mitral valve vegetation, tricuspid valve insufficiency and coronary stenosis were diagnosed and treated by minimally invasive revision cardiac surgery. Conclusion: The present clinical case demonstrates for the first time that the minimally invasive approach via right anterior mini-thoracotomy can be safely used for concomitant complex mitral valve reconstruction, tricuspid valve repair and aorto-coronary bypass surgery, even as a revision procedure in the presence of florid endocarditis after recent neurosurgical intervention. The Covid-19 pandemic and prophylactic patient isolation slow down the efficacy of pulmonary weaning and mobilisation and prolong the need for ICU treatment, without adversely affecting long-term outcome.

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Right Minithoraсotomy as a Standard Approach for Mitral Valve Surgery

Ukrainian journal of cardiovascular surgery ◽

10.30702/ujcvs/20.3803/013023-028 ◽

2020 ◽

pp. 23-28

Author(s):

O. D. Babliak ◽

V. M. Demianenko ◽

D. Y. Babliak ◽

A. I. Marchenko ◽

K. A. Revenko ◽

...

Keyword(s):

Mitral Valve ◽

Minimally Invasive ◽

Mitral Valve Repair ◽

Tricuspid Valve ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Standard Approach ◽

Wound Complications ◽

Tricuspid Valve Repair ◽

Valve Repair

Background. Minimally invasive mitral valve surgery provides many advantages for patients. The aim. To investigate and represent our own experience in minimally invasive mitral valve surgery, and to describe the operative technique. Materials and methods. The study was included 100 consecutive patients who underwent a minimally invasive mitral valve repair or replacement through the right lateral minithoracotomy from June 2017 to December 2019. Results. Mitral valve repair was performed in 87 patients (87%), and 13 patients (13%) were required mitral valve replacement. In 24 patients (24%), concomitant procedures were performed: tricuspid valve repair, atrial septal defect repair and left atrial myxomectomy. Ring anuloplasty was performed in all patients who underwent mitral valve repair. Additional methods of correction were used in accordance to the lesion anatomy: neochords implantation, cleft and leaflet perforation closure, leaflet resection, Alfieri (edge-to-edge) stitch, posterior leaflet plication. There was no in-hospital and 30-day mortality. Post-operative strokes were not reported. No wound complications were observed in the femoral cannulation area. The total length of stay in a hospital was 6 ± 1.46 (3–9) days. There were no cases of mitral valve insufficiency greater more than mild degree after mitral valve repair at the time of discharge. Conclusions. Minimally invasive mitral valve surgery can be performed as a routine standard approach, provides safe and effective correction of the mitral valve defects, allows excellent results of mitral valve repair and replacement in various abnormalities. Minimally invasive approach enables to perform a large number of reconstructive valve techniques and perform simultaneous correction of atrial septal defects, tricuspid valve repair and atrial neoplasm removal.

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