Isolated Tricuspid Valve Surgery: A Single Institutional Experience with the Technique of Minimally Invasive Surgery via Right Minithoracotomy

2015 ◽  
Vol 65 (08) ◽  
pp. 606-611 ◽  
Author(s):  
Jan Minol ◽  
Tobias Weinreich ◽  
Meret Heimann ◽  
Hildegard Gramsch-Zabel ◽  
Payam Akhyari ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Tricuspid Valve ◽  
Surgical Procedure ◽  
Postoperative Mortality ◽  
Air Embolism ◽  
Valve Surgery ◽  
Repair Rate ◽  
Perioperative Morbidity ◽  
Tricuspid Valve Surgery ◽  
Significant Difference

Background Minimally invasive cardiac surgery via right lateral minithoracotomy is a well-described approach. However, reports on isolated tricuspid valve surgery (TVS) in this technique are rare. Therefore, we like to give a contribution by reporting our experience. Methods We retrospectively reviewed 25 tricuspid valve operations via right lateral minithoracotomy with femoral cannulation between August 2009 and September 2013 (18 repairs, 7 replacements, and 72% repair rate). Three patients (12%) presented for a re-do operation, and nine patients (36%) suffered from active endocarditis at admission. All patients underwent TVS as single valve procedure. Ten patients received additional procedures such as removal of infected leads, resection of atrial tumors, or closure of atrial septal defects. An annuloplasty ring was inserted in 12 cases. We investigated the short-term morbidity and mortality with regard to the surgical procedure. Results Repair rate was 72%. Thirty-day and 1-year mortality were 4 and 20%, respectively. The only patient with early mortality received the surgical procedure on the tricuspid valve as fourth cardiac-related surgery and postoperative mortality was due to intracranial air embolism. Perioperative morbidity included reoperation for bleeding (8%) and stroke (4%). No disturbance of wound healing occurred. Durations of intensive care unit stay and hospital stay were 2.3 ± 2.4 and 17.4 ± 13.1 days, respectively. Endocarditis-caused surgery did not reveal any significant difference in the intra- or perioperative course compared with other indications. Conclusion Minimally invasive TVS via right lateral minithoracotomy is feasible with good results. Even in a cohort of patients suffering from elevated rate of active endocarditis, a high repair rate can be achieved.

Right Mini-Thoracotomy for Aortic Plus Mitral with or without Tricuspid Valve Surgery

2020 ◽  
Author(s):  
Gloria Faerber ◽  
Sophie Tkebuchava ◽  
André Scherag ◽  
Maximilian Bley ◽  
Hristo Kirov ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Propensity Score ◽  
Minimally Invasive ◽  
Propensity Score Matching ◽  
Tricuspid Valve ◽  
Valve Surgery ◽  
Tricuspid Valve Surgery ◽  
Triple Valve ◽  
Mini Thoracotomy

Abstract Objectives Minimally invasive surgery is increasingly performed for isolated aortic or mitral valve procedures. However, combined minimally invasive aortic and mitral valve surgery is rare. We report our initial experience performing multiple valve procedures through a right-sided mini-thoracotomy (RMT) compared with sternotomy. Methods A total of 264 patients underwent aortic and mitral with or without tricuspid valve surgery through RMT (n = 25) or sternotomy (n = 239). Propensity score matching was used for outcome comparisons. Results Of the 264 patients, 25 (age: 72 ± 10 years; 72% male) underwent double (n = 19) and triple valve surgery (n = 6) through RMT and 239 (age: 71 ± 11 years; 54% male) underwent double (n = 176) and triple valve surgery (n = 63) through sternotomy. Sternotomy patients had more co-morbidities and preoperative risk factors (EuroSCORE II 10.25 ± 10.89 vs. RMT 3.58. ± 4.98; p < 0.001). RMT procedures were uneventful without intraoperative complications or conversions to sternotomy. After propensity score matching, surgical procedures were comparable between groups with a higher valve repair rate in RMT. Despite longer cardiopulmonary bypass times in RMT, there was no evidence for differences in 30-day mortality (RMT: n = 2 vs. sternotomy: n = 2) and there were no significant differences in other outcomes. During 5-year follow-up, reoperation was required in sternotomy patients only (n = 2). Follow-up echocardiography showed durable results after valve surgery. RMT patients showed higher survival probability compared with sternotomy, although this difference was not significant (hazard ratio = 0.33; 95% confidence interval: 0.06–1.65; p = 0.18). Conclusion Combined aortic plus mitral with or without tricuspid valve surgery can safely be performed through a RMT with a trend toward better mid-term outcomes.

scholarly journals Isolated Tricuspid Valve Surgery – Repair Versus Replacement: a Meta-analysis

2021 ◽  
Author(s):  
Panagiotis Sarris-Michopoulos ◽  
Alejandro Macias ◽  
Constantine Sarris-Michopoulos ◽  
Palina Woodhouse ◽  
Daniel Buitrago ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Publication Bias ◽  
Tricuspid Valve ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Valve Surgery ◽  
Tricuspid Valve Repair ◽  
Tricuspid Valve Surgery ◽  
Significant Difference ◽  
Pacemaker Placement

Objective: There is paucity of data on outcomes after isolated tricuspid valve surgery. This meta-analysis aims to compile available data on isolated tricuspid valve surgery and compare isolated tricuspid valve repair (iTVr) with isolated tricuspid valve replacement (iTVR) to elucidate outcomes after tricuspid valve surgery. Methods: A literature search of 6 databases was performed. The primary outcomes was 30-day mortality. Secondary outcomes were early stroke, post-op pacemaker placement, and tricuspid reoperation within 5 years. Publication bias was explored using the funnel plot. Results: Ten retrospective studies involving 1407 patients (iTVr group = 779 patients and iTVR group = 628 patients) were included. A cumulative analysis demonstrated a significant difference favoring iTVr for 30-day mortality [odds ratio – 10 studies (95% confidence interval) 0.34 (0.18-0.66)]; 4.7% versus 12.6%, for iTVr and iTVR, respectively. Post-op pacemaker placement favored iTVr [odds ratio – 6 studies (95% confidence interval) 0.37 (0.18-0.77)]. Although stroke rates and TV reoperation favored iTVr, they did not reach statistical significance. No publication bias was identified. Conclusions: This meta-analysis demonstrates that iTVr has better 30-day mortality and fewer permanent pacemaker placements. Etiology and severity of TR, as well as careful patient selection remain the most important factors for optimal outcomes.

The Endovascular Coronary Sinus Catheter in Minimally Invasive Mitral and Tricuspid Valve Surgery: A Case Series

2010 ◽  
Vol 24 (5) ◽  
pp. 746-751 ◽  
Author(s):  
Jean-Sébastien Lebon ◽  
Pierre Couture ◽  
Antoine G. Rochon ◽  
Éric Laliberté ◽  
Julie Harvey ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Tricuspid Valve ◽  
Coronary Sinus ◽  
Case Series ◽  
Valve Surgery ◽  
Tricuspid Valve Surgery ◽  
Coronary Sinus Catheter

Operative Outcomes of Concomitant Minimally Invasive Mitral and Tricuspid Valve Surgery

2019 ◽  
Vol 14 (5) ◽  
pp. 412-418
Author(s):  
Arman Kilic ◽  
Wilson Y. Szeto ◽  
Pavan Atluri ◽  
Michael A. Acker ◽  
W. Clark Hargrove
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Tricuspid Valve ◽  
Operative Mortality ◽  
Length Of Hospital Stay ◽  
Valve Surgery ◽  
Operative Outcomes ◽  
Tricuspid Valve Surgery ◽  
Port Access ◽  
Access Right

Objective The aim of this study was to evaluate whether the addition of concomitant tricuspid valve surgery (TVS) negatively impacted operative outcomes of minimally invasive mitral valve surgery (MIMVS). Methods Patients undergoing MIMVS via a port-access right minithoracotomy between 2002 and 2014 at a single institution were reviewed. Patients were primarily stratified by those undergoing isolated MIMVS versus MIMVS+TVS. Propensity-matched cohorts were generated. Operative outcomes were compared between the propensity-matched cohorts and included operative mortality, complications, and length of hospital stay. Results A total of 1,158 patients underwent MIMVS via port-access right minithoracotomy. The majority of cases were elective (93%; n = 1,071) and 148 (13%) underwent concomitant MIMVS + TVS. Patients undergoing MIMVS + TVS were at higher risk at baseline. After propensity-matching, there were 119 isolated MIMVS and 119 MIMVS + TVS patients that were well matched with respect to all baseline variables. Cardiopulmonary bypass (148 ± 54 minutes versus 175 ± 54 minutes, P < 0.001) and aortic occlusion times (105 ± 36 minutes versus 128 ± 40 minutes, P < 0.001) were longer in the MIMVS + TVS group. Operative mortality was comparable (3% isolated MIMVS versus 4% for MIMVS + TVS; P = 0.73). Permanent pacemakers were required less frequently in the isolated MIMVS group (1% versus 6%; P = 0.03). All other complication rates were similar. Median length of hospital stay (7 versus 8 days; P = 0.13) and discharge-to-home rates (89% versus 94%; P = 0.15) were comparable. Conclusions Despite longer operative times, minimally invasive TVS performed concomitantly with MIMVS has similar operative outcomes with the exception of a higher pacemaker rate when compared with isolated MIMVS.

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