scholarly journals Outcomes of Tricuspid Valve Detachment for Isolated Ventricular Septal Defect Closure

2021 ◽  
Vol 69 (S 03) ◽  
pp. e48-e52
Author(s):  
John Schittek ◽  
Jörg S. Sachweh ◽  
Florian Arndt ◽  
Maria Grafmann ◽  
Ida Hüners ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Tricuspid Valve ◽  
Septal Defect ◽  
Control Group ◽  
Av Block ◽  
Residual Shunt ◽  
Surgical Closure ◽  
Perimembranous Ventricular Septal Defect ◽  
Ventricular Septal Defect Closure ◽  
Valve Detachment

AbstractPartial detachment of the septal and anterior leaflets of the tricuspid valve (TV) is a technique to visualize a perimembranous ventricular septal defect (VSD) for surgical closure in cases where the VSD is obscured by TV tissue. However, TV incision bears the risk of causing relevant postoperative TV regurgitation and higher degree atrioventricular (AV) block. A total of 40 patients were identified retrospectively in our institution who underwent isolated VSD closure between January 2013 and August 2015. Visualization of the VSD was achieved in 20 patients without and in 20 patients with additional partial detachment of the TV. The mean age of patients with partial tricuspid valve detachment (TVD) was 0.7 ± 0.1 years compared with 1 ± 0.3 years (p = 0.22) of patients without TVD. There was no difference in cardiopulmonary bypass time between patients of both groups (123 ± 11 vs. 103 ± 5 minutes, p = 0.1). Cross-clamp time was longer if the TV was detached (69 ± 5 vs. 54 ± 4 minutes, p = 0.023). There was no perioperative mortality. Echocardiography at discharge and after 2.5 years (2 months–6 years) of follow-up showed neither a postoperative increase of tricuspid regurgitation nor any relevant residual shunt. Postoperative electrocardiograms were normal without any sign of higher degree AV block. TVD offers enhanced exposure and safe treatment of VSDs. It did not result in higher rates of TV regurgitation or relevant AV block compared with the control group.

Temporary Tricuspid Valve Detachment for Ventricular Septal Defect Closure: Is It Worth Doing It?

2015 ◽  
Vol 16 (2) ◽  
pp. 99
Author(s):  
Alexander Weymann ◽  
Stanimir Georgiev ◽  
Carsten Vogelsang ◽  
Annette Ivad ◽  
Matthias Karck ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Septal Defect ◽  
Control Group ◽  
Ventricular Septal Defects ◽  
Residual Shunt ◽  
Septal Defects ◽  
Ventricular Septal Defect Closure ◽  
Potential Risks ◽  
Valve Detachment

<p><b>Background:</b> Tricuspid valve detachment (TVD) may improve the access for closing certain ventricular septal defects (VSDs), but it has some potential risks. We aimed to study the benefits and drawbacks of this technique.</p><p><b>Methods:</b> The midterm outcomes of all 20 patients who underwent a TVD closure for VSD were reviewed and compared with a control group of 15 patients with VSD closure without TVD.</p><p><b>Results:</b> There was no significant residual shunt in either group at the last actuarial follow-up. Tricuspid regurgitation occurred in both groups (45% in the TVD group and 27% in the control group, <i>P</i> = .48). These lesions were considered insignificant in all patients. There were no atrioventricular blocks, and all patients were in sinus rhythm. The cardiopulmonary bypass times were significantly higher in the TVD group than in the control group (91.6 � 17.2 minutes versus 68.3 � 15.7 minutes, <i>P</i> ? .01), as were the aortic cross-clamping times (50.7 � 12.1 minutes versus 35.9 � 14.4 minutes, <i>P</i> ? .01).</p><p><b>Conclusion:</b> Our results, along with results from other series, suggest that TVD can be used effectively and safely for closure of certain VSDs.</p>

scholarly journals Does tricuspid valve detachment improve outcomes compared with the non-tricuspid valve detachment approach in ventricular septal defect closure?

2020 ◽  
Author(s):  
Yunfei Ling ◽  
Xiaohui Bian ◽  
Yue Wang ◽  
Yongjun Qian
Keyword(s):  
Cardiopulmonary Bypass ◽  
Ventricular Septal Defect ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
The Other ◽  
Cardiopulmonary Bypass Time ◽  
Significant Difference ◽  
Ventricular Septal Defect Closure ◽  
Valve Detachment

Summary A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the tricuspid valve detachment (TVD) approach to ventricular septal defect repair provides superior outcomes compared with the non-TVD approach. Altogether more than 54 papers were found using the reported search, of which 10 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. A total of 2059 participants were enrolled in the 10 studies, including 2 prospective studies and 8 retrospective studies. Six studies demonstrated a longer cardiopulmonary bypass time or aortic clamp time in the TVD group, whereas 4 studies showed no difference. Only 1 study reported a lower incidence of trivial tricuspid regurgitation in the TVD group, whereas the other 9 studies showed no significant difference. One study showed that a higher incidence of residual shunting occurred in those patients who had indications for TVD but did not perform detachment during surgery. No difference in postoperative residual shunting was demonstrated in the other 9 studies. We conclude that surgeons should be reassured that if TVD is required to repair the ventricular septal defect, although it may lead to longer cardiopulmonary bypass time and cross-clamp times, outcomes are equivalent in terms of the degree of tricuspid regurgitation and incidence of the residual ventricular septal defect.

Liberal use of tricuspid valve detachment for transatrial ventricular septal defect closure

2003 ◽  
Vol 76 (4) ◽  
pp. 1073-1077 ◽  
Author(s):  
Ryo Aeba ◽  
Toshiyuki Katogi ◽  
Kenichi Hashizume ◽  
Kiyoshi Koizumi ◽  
Yoshimi Iino ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Tricuspid Valve ◽  
Septal Defect ◽  
Defect Closure ◽  
Ventricular Septal Defect Closure ◽  
Valve Detachment

scholarly journals Tricuspid Valve Detachment in Ventricular Septal Defect Closure Does Not Impact Valve Function

2018 ◽  
Vol 106 (1) ◽  
pp. 145-150
Author(s):  
Charles D. Fraser ◽  
Xun Zhou ◽  
Sandeep Palepu ◽  
Cecillia Lui ◽  
Alejandro Suarez-Pierre ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Tricuspid Valve ◽  
Septal Defect ◽  
Defect Closure ◽  
Ventricular Septal Defect Closure ◽  
Valve Function ◽  
Valve Detachment

Tricuspid valve detachment for ventricular septal defect closure in infants <5 kg: should we be hesitant?

2021 ◽  
Author(s):  
Jae Hong Lee ◽  
Sungkyu Cho ◽  
Jae Gun Kwak ◽  
Hye Won Kwon ◽  
Yujin Kwak ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Clinical Outcomes ◽  
Tricuspid Valve ◽  
Septal Defect ◽  
Propensity Score Matching Analysis ◽  
All Cause Mortality ◽  
Ventricular Septal Defect Closure ◽  
Group D ◽  
Valve Detachment

Abstract OBJECTIVES We compared the clinical outcomes between tricuspid valve detachment (TVD) and non-TVD for ventricular septal defect (VSD) closure in infants &lt;5 kg. METHODS From January 2004 to April 2020, 462 infants &lt;5 kg with VSD without more complex intracardiac lesions and who had undergone VSD closure through the trans-atrial approach were enrolled. Propensity score-matching analysis was performed. Clinical outcomes were compared between the paired TVD group (group D) and paired non-TVD group (group N). RESULTS The median age and body weight at operation were 1.9 months [interquartile range(IQR), 1.4–2.5] and 4.2 kg (IQR, 3.7–4.6). The median follow-up duration was 83.4 months (IQR, 43.5–130.4). After matching, 44 pairs were extracted from each group. There were no significant differences in all-cause mortality (P = 0.176), reoperation (P = 0.172), postoperative morbidities, including residual VSD, aortic regurgitation, atrioventricular block and significant tricuspid regurgitation (TR) (P = 0.346) between group D and group N. However, group D showed significantly less TR progression during follow-up (P = 0.019). CONCLUSIONS In infants &lt;5 kg, TVD can be a reasonable and valid option for successful VSD closure without morbidities, including TR progression if the indication exists.

Epicardial blebs and septal hematoma after ventricular septal defect closure

2020 ◽  
Vol 28 (6) ◽  
pp. 336-338
Author(s):  
Joyce Mary Jose ◽  
Sri Rama Ananta Nagabhushanam Padala ◽  
Sundararaj Rajkumar ◽  
Sreevathsa KS Prasad ◽  
Ajay Kumar Jha
Keyword(s):  
Cardiopulmonary Bypass ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Defect Closure ◽  
Perimembranous Ventricular Septal Defect ◽  
Ventricular Septal Defect Closure ◽  
Life Threatening ◽  
Patch Closure

Rapidly progressive epicardial hemorrhagic blebs during weaning from cardiopulmonary bypass after perimembranous ventricular septal defect closure has not been reported previously. Here, we describe the case of a 3-month-old baby with life-threatening epicardial hemorrhagic blebs and an interventricular septal hematoma after perimembranous ventricular septal defect patch closure.

Sign in / Sign up

Export Citation Format

Share Document