RESIDUAL TRICUSPID REGURGITATION FOLLOWING TRICUSPID VALVE REPAIR DURING CONCOMITANT VALVE SURGERY DOES NOT WORSEN OVERALL SURVIVAL

Background: Concomitant tricuspid valve repair (TVr) for functional tricuspid regurgitation (TR) at the time of left-sided valve surgery has become increasingly more common over the past decade. The impact of residual post-repair TR on late outcomes remains unclear. Methods: All patients undergoing TVr during concomitant left-sided valve surgery at our institution from 2005-2012 were retrospectively reviewed. Patients were stratified into 2 groups according to the degree of post-cardiopulmonary bypass TR observed on intraoperative transesophageal echocardiography; 0-1+ TR (No TR, n = 246) and ≥2+ TR (Residual TR, n = 26). Primary outcomes of interest were 30-day survival, 4-year survival, and follow-up TR grade. A propensity-matched subgroup analysis was performed in addition to the overall cohort analysis. Results: Mean age for all patients was 70.3 ± 13.0 years and 107 (39%) patients were male. There was no difference in 30-day survival between groups (92% No TR versus 96% Residual TR, P = .70). Kaplan-Meier analysis of overall 4-year survival showed a trend toward worsened survival in the Residual TR group (log rank P = .17) and propensity-matched subgroup analysis showed significantly worse 4-year survival for Residual TR (log rank P = .02). At mean echocardiographic follow up of 11.9 ± 22.5 months, TR grade was significantly worse in the Residual TR group compared to No TR (1.5 ± 0.8 Residual TR versus 0.9 ± 0.9 No TR, P = .005), although TR severity was significantly improved from immediately post-bypass. Conclusions: Patients left with residual TR following TVr during concomitant left-sided valve surgery have significantly decreased late survival compared to patients left with no post-repair TR.

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Minimally Invasive Isolated Tricuspid Valve Repair: the Trend for Redo Tricuspid Valve Surgery

10.21203/rs.3.rs-410036/v1 ◽

2021 ◽

Author(s):

Xiaoyi Dai ◽

Peng Teng ◽

Sihan Miao ◽

Wei Si ◽

Qi Zheng ◽

...

Keyword(s):

Minimally Invasive ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Nyha Class ◽

Valve Surgery ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Tricuspid Valve Surgery ◽

The Mean

Abstract Background: Tricuspid regurgitation after left-sided valve surgery was associated with terrible outcomes and high perioperative mortality for redo surgical treatment. In current years, minimally invasive redo isolated tricuspid valve repair is increasingly performed in our institution to address tricuspid regurgitation. Methods: Thirty-seven consecutive patients with previous left-sided valve surgery underwent minimally invasive redo isolated tricuspid valve repair in our institution between November 2017 and December 2020. Twenty-nine patients(78.4%) were women and the mean age of patients was 58.4±8.5 years. Follow-up was 100% complete with a mean follow-up time of 16.8±9.4 months.Results: Both the in-hospital and 30-day mortalities were 2.7%. The overall NYHA class had improved significantly during the follow-up(p＜0.001). The grade of TR had decreased before discharge(p＜0.001) and during the follow-up(p＜0.001) compared with the preoperative level although severe TR was recurrent in one patient.Conclusions: Minimally invasive redo isolated tricuspid valve repair has remarkable early and midterm outcomes, may be the preferred surgical option to address tricuspid regurgitation after previous left-sided valve surgery when it is feasible.

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Severe tricuspid regurgitation after mitral valve surgery: the risk factors and results of the aggressive application of prophylactic tricuspid valve repair

Surgery Today ◽

10.1007/s00595-016-1395-4 ◽

2016 ◽

Vol 47 (4) ◽

pp. 445-456 ◽

Cited By ~ 7

Author(s):

Hiroshi Takano ◽

Miyoko Hiramatsu ◽

Hirota Kida ◽

Mitsuru Uenoyama ◽

Kei Horiguchi ◽

...

Keyword(s):

Risk Factors ◽

Mitral Valve ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Severe Tricuspid Regurgitation

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Role of Tricuspid Valve Repair for Moderate Tricuspid Regurgitation during Minimally Invasive Mitral Valve Surgery

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0033-1333844 ◽

2013 ◽

Vol 61 (05) ◽

pp. 386-391 ◽

Cited By ~ 13

Author(s):

Alexander Verevkin ◽

Michael Borger ◽

Meinhard Mende ◽

Piroze Davierwala ◽

Jens Garbade ◽

...

Keyword(s):

Mitral Valve ◽

Minimally Invasive ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Tricuspid Valve Repair ◽

Valve Repair

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Faculty Opinions recommendation of Long-Term Outcomes of the FORMA Transcatheter Tricuspid Valve Repair System for the Treatment of Severe Tricuspid Regurgitation: Insights From the First-in-Human Experience.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.736343783.793580323 ◽

2020 ◽

Author(s):

Michele De Bonis ◽

Benedetto Del Forno

Keyword(s):

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Human Experience ◽

Tricuspid Valve Repair ◽

Repair System ◽

Valve Repair ◽

Long Term Outcomes ◽

Severe Tricuspid Regurgitation

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Tricuspid Valve Repair for the Poor Right Ventricle: Tricuspid Valve Repair in Patients with Mild-to-Moderate Tricuspid Regurgitation Undergoing Mitral Valve Repair Improves In-Hospital Outcome

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0034-1399783 ◽

2015 ◽

Vol 65 (08) ◽

pp. 612-616 ◽

Cited By ~ 2

Author(s):

Michele Genoni ◽

Kirk Graves ◽

Dragan Odavic ◽

Helen Löblein ◽

Achim Häussler ◽

...

Keyword(s):

United States ◽

Mitral Valve ◽

Blood Transfusion ◽

Right Ventricle ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Operation Time ◽

Tricuspid Valve Repair ◽

Cell Saver ◽

Valve Repair

Background Tricuspid regurgitation (TR) in patients undergoing surgery for mitral valve (MV) increases morbidity and mortality, especially in case of a poor right ventricle. Does repair of mild-to-moderate insufficiency of the tricuspid valve (TV) in patients undergoing MV surgery lead to a benefit in early postoperative outcome? Methods A total of 22 patients with mild-to-moderate TR underwent MV repair and concomitant TV repair with Tri-Ad (Medtronic ATS Medical Inc., Minneapolis, Minnesota, United States) and Edwards Cosgrove (Edwards Lifesciences Irvine, California, United States) rings. The severity of TR was assessed echocardiographically by using color-Doppler flow images. The tricuspid annular plane systolic excursion (TAPSE) was under 1.7 cm. Additional procedures included coronary artery bypass (n = 9) and maze procedure (n = 15). The following parameters were compared: postoperative and peak dose of noradrenaline (NA), pre/postoperative systolic pulmonary pressure (sPAP), extubation time, operation time, cross-clamp time, cardiopulmonary bypass (CPB) time, pre/postoperative ejection fraction (EF), intensive care unit (ICU)-stay, hospital stay, cell saver blood transfusion, intra/postoperative blood transfusion, and postoperative TR. Results The mean age was 67 ± 14.8 years, 45% were male. Mean EF was 47 ± 16.2%, postoperative 52 ± 12.4%. sPAP was 46 ± 20.1 mm Hg preoperatively, sPAP was 40.6 ± 9.4 mm Hg postoperatively, NA postoperatively was 12 ± 10 μg/min, NA peak was 18 ± 11 μg/min, operation time was 275 ± 92 minutes, CPB was 145 ± 49 minutes, ICU stay was 2.4 ± 2.4 days, hospital stay was 10.8 ± 3.5 days, cell saver blood transfusion was 736 ± 346 mL, intraoperative transfusions were 2.5 ± 1.6. Two patients needed postoperative transfusions. A total of 19 patients were extubated at the 1st postoperative day, 2 patients at the 2nd day, and 1 at the 4th postoperative day. Two patients required a pacemaker. No reintubation, no in-hospital mortality, and one reoperation because of bleeding complications. Conclusion Correction of mild-to-moderate TR at the time of MV repair does maintain TV function and avoid right ventricular dysfunction in the early postoperative period improving the clinical outcome.

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