scholarly journals Uni-Port Total Thoracoscopic Surgery Versus Median Sternotomy for Redo Tricuspid Valve Replacement: A Retrospective Study

2020 ◽  
Vol 23 (3) ◽  
pp. E350-E357
Author(s):  
Licheng Yan ◽  
Fuzhen Zheng ◽  
Haiyu Chen ◽  
Jiayin Bao ◽  
Guoxing Weng
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Thoracoscopic Surgery ◽  
Median Sternotomy ◽  
Control Group ◽  
Study Group ◽  
Valve Regurgitation ◽  
Tricuspid Valve Replacement ◽  
Tricuspid Valve Regurgitation

Background: This study compared the perioperative and follow-up period data of patients who underwent redo tricuspid valve replacements performed via thoracoscopic surgery or median sternotomy. The purpose was to evaluate the feasibility, safety, and surgical outcomes of redo tricuspid valve replacement via uni-port thoracoscopic surgery. Methods: Forty-nine patients with severe tricuspid valve regurgitation after left-side valve replacement underwent redo tricuspid valve replacements in our hospital from April 2012 to September 2019. Twenty-six patients underwent uni-port total thoracoscopy surgery, whereas 23 patients had the surgery performed via median sternotomy. We collected perioperative and 3- to 36-month postoperative data. Results: No deaths occurred in the intraoperative period. Time of cardiopulmonary bypass in the study group significantly was longer than that in the control group (P < .05), but the operative times in the study and control groups were not significantly different. Thoracic drainage, length of ICU stay, postoperative hospital stay, and complication rates in the study group were significantly different from those in the control group (P < .05). Throughout the follow-up period, uni-port total thoracoscopic TVR was not inferior to traditional surgery with respect to cardiac function and recurrence of tricuspid valve regurgitation. Conclusions: Uni-port total thoracoscopic tricuspid valve replacement is safe,  feasible and effective, and that can be considered as a primary treatment strategy for patients with severe TR after previous left-sided valve procedure.

scholarly journals Uni-port total thoracoscopic surgery versus median sternotomy for redo tricuspid valve replacement: A retrospective study

2020 ◽  
Author(s):  
Licheng Yan ◽  
Fuzhen Zheng ◽  
Haiyu Chen ◽  
Jiayin Bao ◽  
Guoxing Weng
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Thoracoscopic Surgery ◽  
Median Sternotomy ◽  
Control Group ◽  
Study Group ◽  
Valve Regurgitation ◽  
Tricuspid Valve Replacement ◽  
Tricuspid Valve Regurgitation

Abstract BACKGROUNDː This study compared the perioperative and follow-up period data of patients who underwent redo tricuspid valve replacements performed via thoracoscopic surgery or median sternotomy. The purpose was to evaluate the feasibility, safety, and surgical outcomes of redo tricuspid valve replacement via uni-port thoracoscopic surgery. METHODSː Forty-nine patients with severe tricuspid valve regurgitation after left-side valve replacement underwent redo tricuspid valve replacements in our hospital from April 2012 to September 2019. 26 patients underwent uni-port total thoracoscopy surgery, whereas 23 patients had the surgery performed via median sternotomy. We collected perioperative and 3- to 36-month postoperative data. RESULTSː No deaths occurred in the intraoperative period. Time of cardiopulmonary bypass in the study group was significantly longer than that in the control group (P<0.05), but the operative times in the study and control groups were not significantly different. Thoracic drainage, length of ICU stay, postoperative hospital stay and complication rates in the study group were significantly different from those in the control group (P<0.05). Throughout the follow-up period, uni-port total thoracoscopic TVR is not inferior to traditional surgery with respect to cardiac function and recurrence of tricuspid valve regurgitation. CONCLUSIONSː Uni-port total thoracoscopic tricuspid valve replacement is safe, feasible and effective, and that can be considered as a primary treatment strategy for patients with severe TR after previous left-sided valve procedure.

P1878Long-term effect of atrial fibrillation on the evolution of mitral and tricuspid valve regurgitation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Pype ◽  
L Embrechts ◽  
B Cornez ◽  
C Van Paesschen ◽  
A Sarkozy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Tricuspid Valve ◽  
Rhythm Control ◽  
Volume Index ◽  
Integrative Approach ◽  
Control Group ◽  
Valve Regurgitation ◽  
Tricuspid Valve Regurgitation ◽  
Atrial Remodelling

Abstract Background While severe mitral regurgitation is a well-established risk factor for atrial fibrillation (AF), it is less known whether atrial fibrillation induces mitral/tricuspid valve regurgitation (MR/TR). The present study aims to identify the long-term effects of permanent or non-permanent AF on atrial remodelling and on the progression of MR/TR. Methods The severity of MR/TR was assessed at baseline and after a period of 65±10 months in 37 patients with permanent AF, in 80 patients with non-permanent AF (of whom 43 were treated with ablation) and in 53 control patients with persistent sinus rhythm. MR/TR was qualitatively assessed by the multi-integrative approach, and quantitatively by measurement of the colour jet area. Results At baseline, AF patients had larger MR jet areas than control patients. At follow up, progression of MR, expressed as delta MR jet area, was 0.05±1.3 cm2 in the control group, 0.73±2.1 cm2 in the non-permanent AF group and 1.95±3.6 cm2 in the permanent AF group (p=0.001). Severe MR at follow up was observed in 0%, 2.5%, 8%, respectively. After adjustment for baseline clinical and echocardiographic parameters, permanent AF remained independently associated with the progression of MR. There was a significant positive correlation between a progression of MR and an increase in left atrial volume index (r=0.31, p<0.001). Although rhythm control in non-permanent AF patients was better with AF ablation than with medical treatment only, the MR evolution was similar (delta MR jet area: 0.85±2.05 cm2 vs 0.61±2.12 cm2, p=0.6). Comparable findings, albeit less pronounced, were observed for the association between of AF and TR progression. MR jet area Conclusions The presence of longstanding AF is associated with a significant progression of MR/TR mainly due to atrial remodelling. Our data showed a beneficial effect of sustained rhythm control, either medically or by ablation, on MR/TR progression.

scholarly journals Long-term follow-up of resection of primary benign right ventricular tumours: a 10-year surgical experience

2021 ◽  
Vol 103 (1) ◽  
pp. 53-58
Author(s):  
E Qiao ◽  
Y Wang ◽  
Z Huang ◽  
F Li ◽  
W Wang
Keyword(s):  
Right Ventricular ◽  
Valve Replacement ◽  
Tricuspid Valve ◽  
Survival Rates ◽  
Perioperative Period ◽  
Good Prognosis ◽  
Clinical Findings ◽  
Tumour Resection ◽  
Tricuspid Valve Replacement

Introduction Primary benign right ventricular tumours are rare. They can cause significant mortality without appropriate and timely treatment. We investigated surgical treatment and survival characteristics for right ventricular tumours. Materials and methods From 2007 to 2017, 21 patients with primary benign right ventricular tumours who underwent tumour resection were retrospectively reviewed. Clinical findings and follow-up results were analysed. Results Thirteen men and eight women were enrolled, with a mean age of 42.3 ± 15.3 years. The most frequent histotypes were myxoma, haemangioma and papillary fibroelastoma. Eight patients underwent concomitant tricuspid valvuloplasty and one had tricuspid valve replacement. No major adverse events or death occurred during the perioperative period. One patient with haemangioma underwent partial tumour resection; however, the tumour regressed gradually during follow-up. Within the 10-year follow-up period (mean 4.8 ± 2.6 years), the recurrence-free and overall survival rates were 81.0% and 85.7%, respectively. Conclusions Tumour resection for primary benign right ventricular tumours is safe and effective, and has a good prognosis. Tricuspid valvuloplasty or tricuspid valve replacement may be necessary for the resection of right ventricular tumours to improve the haemodynamics. Haemangiomas naturally undergo spontaneous regression.

scholarly journals Dura mater mitral and tricuspid bioprostheses: 30 years of follow-up

2003 ◽  
Vol 58 (3) ◽  
pp. 163-168 ◽  
Author(s):  
Luiz Boro Puig ◽  
Carlos Manuel de Almeida Brandão ◽  
Lauro Kawabe ◽  
Geraldo Verginelli ◽  
José Antonio Francchini Ramires ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Dura Mater ◽  
Clinical Results ◽  
Tricuspid Valve Replacement ◽  
Actuarial Survival ◽  
Valve Dysfunction ◽  
The University ◽  
Lost To Follow Up

PURPOSE: The dura mater bioprosthesis was developed in the Department of Cardiopneumology of the Hospital das Clínicas of the University of São Paulo Medical School in 1971. Here, we present the clinical results of the dura mater bioprosthesis over 30 years of follow-up. METHODS: We studied 70 consecutive patients who underwent mitral or tricuspid valve replacement with a dura mater bioprosthesis between January 1971 and August 1972. RESULTS: The early mortality was 10% (7 patients). The follow-up was 87% complete (9 patients were lost to follow-up). Two patients were alive and asymptomatic 30 years after valve replacement; 33 patients underwent reoperations due to valve dysfunction, and 19 died during the follow-up period. At 30 years, the actuarial survival was 49.2 ± 8.6%; freedom from rupture, 27.0 ± 10.2%; freedom from calcification, 78.8 ± 8.6%; and freedom from reoperation, 18.8 ± 7.5%. CONCLUSIONS: The dura mater bioprosthesis played an important role in the treatment of patients with mitral and tricuspid valve disease. The low rate of thromboembolism and the long period of follow-up without evidence of valve dysfunction, which occurred for several of our patients, are important characteristics of these bioprosthesis.

scholarly journals The Risk and Outcomes of Reoperative Tricuspid Valve Replacement Surgery

2020 ◽  
Vol 23 (5) ◽  
pp. E658-E664
Author(s):  
Cheng Chen ◽  
Min Ge ◽  
Jiaxin Ye ◽  
Yongqing Cheng ◽  
Tao Chen ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Valve Replacement ◽  
Tricuspid Valve ◽  
Cardiovascular Surgery ◽  
Univariate Analysis ◽  
Apache Ii ◽  
Tricuspid Valve Replacement ◽  
Ventilation Time ◽  
Mechanical Ventilation Time

Objectives: Functional tricuspid regurgitation (TR) usually occurs with previous cardiovascular surgery, which causes right-side heart failure and affects patient prognosis. Thus, we aimed to assess the risk and outcomes of isolated tricuspid valve replacement (TVR) after cardiovascular surgery. Methods: We reviewed our hospital medical records and found 107 patients, who had undergone TVR following cardiovascular surgery from June 2009 to November 2017. Follow up was performed by telephone calls, with a mean follow up of 51 months (one to 120 months). Previous surgical procedures of all patients were recorded, and we compared the differences in baseline and preoperative characteristics between the survival and non-survival groups by univariate analysis. Furthermore, logistic regression analysis was performed to identify the risk factors. The variables with a P value < .05 on univariate analysis were entered into a multivariate analysis using stepwise selection. Results: TVR was performed in 107 patients, including 89 survivors and 18 non-survivors during the follow up. There were 38 male and 69 female patients, and the mean age was 53.55 years. Hospital mortality was 16.8% (18/107). The APACHE II (P < .001) and mechanical ventilation time (P = .001) were higher in the non-survival group. The values of B-type natriuretic peptide (BNP), total bilirubin (TB), and blood urea nitrogen (BUN) before and after the operation and some preoperative values were different between the two groups (P < .05). The logistic regression analysis showed that APACHE II score, mechanical ventilation time, preoperative albumin, and postoperative TB were risk factors for TVR after cardiovascular surgery. Conclusions: Reoperation tricuspid valve replacement is associated with high operative mortality. High APACHE II scores, mechanical ventilation time and postoperative TB were associated with increased short-term mortality risk, while high preoperative albumin levels decreased the risk. Positive reoperation for tricuspid valve prosthesis dysfunction can obtain satisfactory therapeutic effects, and survivors could benefit from the surgery.

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