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 ◽  
...  

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.

2001 ◽  
Vol 71 (1) ◽  
pp. 105-109 ◽  
Author(s):  
Kiyoharu Nakano ◽  
Hatsue Ishibashi-Ueda ◽  
Junjiro Kobayashi ◽  
Yoshikado Sasako ◽  
Toshikatsu Yagihara

2021 ◽  
Vol 103 (1) ◽  
pp. 53-58
Author(s):  
E Qiao ◽  
Y Wang ◽  
Z Huang ◽  
F Li ◽  
W Wang

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.


2020 ◽  
Author(s):  
Licheng Yan ◽  
Fuzhen Zheng ◽  
Haiyu Chen ◽  
Jiayin Bao ◽  
Guoxing Weng

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.


2006 ◽  
Vol 81 (4) ◽  
pp. 1317-1324 ◽  
Author(s):  
Byung-Chul Chang ◽  
Sang-Hyun Lim ◽  
Gijong Yi ◽  
You Sun Hong ◽  
Sak Lee ◽  
...  

2020 ◽  
Vol 23 (5) ◽  
pp. E658-E664
Author(s):  
Cheng Chen ◽  
Min Ge ◽  
Jiaxin Ye ◽  
Yongqing Cheng ◽  
Tao Chen ◽  
...  

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.


2014 ◽  
Vol 43 (3) ◽  
pp. 97-100
Author(s):  
Seiji Matsukuma ◽  
Kiyoyuki Eishi ◽  
Koji Hashizume ◽  
Tsuneo Ariyoshi ◽  
Shinichiro Taniguchi ◽  
...  

Author(s):  
T. V. Glushkova ◽  
E. A. Ovcharenko ◽  
A. V. Batranin ◽  
K. Yu. Klyshnikov ◽  
Yu. A. Kudryavtseva ◽  
...  

Aim. To assess the contribution of pannus and calcification to the development of bioprosthetic valve dysfunction after tricuspid valve replacement in a pediatric patient.Materials and methods. A 3-month-old patient presented with tricuspid valve  dysplasia and grade 4 tricuspid insufficiency underwent tricuspid valve  replacement with the bioprosthesis «PeriCor» (ZAO «NeoKor», Russian  Federation). The patient at the age of 6 years required a redo tricuspid valve  replacement 5 years 8 months after initial surgery. Degenerative changes of the  dysfunctional bioprosthetic valve explanted from the tricuspid position were  assessed using macroscopic description and light microscopy. Cellular  composition, the presence of bacteria, colocalization of calcifications with  recipient cells were analyzed. The distribution of calcifications and their volume  in the biomaterial tissue were estimated using microcomputer tomography imaging (micro-CT).Results. Bioprosthetic valve dysfunction was mainly caused by the pannus  formation which was shown to encapsulate the anterior leaflet, resulting in its  total failure and severe stenosis (reduced effective orifice area). There were no  signs of ruptures and perforations in the valve tissues found. All leaflets were  shown to contain predominantly fibroblastic cells and single blood cells, mainly located in the surface layers of the leaflets in the regions without any  signs of calcification. Bacteria staining was negative for all types of the studied biomaterials. Calcifications were present in all xeno-tissue elements of the  explanted bioprosthesis (i.e. leaflets, aortic segment, and pericardium). In  addition, calcifications were also found in pannus growing during a functioning  bioprosthetic valve. Calcifications were predominantly located in the co-optation  and commissure zones of the leaflets. Importantly, massive calcifications were  observed around the bioprosthetic stent frame. The total volume of calcification  accounted for 1/3 of the biological component of the bioprosthesis (729 mm3).Conclusion. According to the data obtained in this study, we may conclude that the primary cause of the bioprosthesis failure was the growth of connective  tissues, resulting in pannus-related dysfunction, rather than severe calcification  of all bioprosthetic components. One may assume that bioprosthetic dysfunction  is related to the peculiarity of the inflammatory response of the preschool  patient. However, this typeof dysfunctions requires further investigation.


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