HighlightsThe authors have studied anemia`s impact on the long-term mortality after mitral valve surgery. The research results indicate the need to address this modifiable factor in the preoperative period. Aim. To analyze the impact of anemia on the long-term survival of patients after mitral valve surgery.Methods. The study included 103 patients, 46 of them were men, 57 were women. Thirteen patients presented with anemia before surgery, and 90 patients did not have anemia. The survival rate of patients was compared using the Kaplan-Meier estimate.Results. The survival rate after surgery in the group of patients without anemia was higher compared with patients with anemia (p = 0,002). By the end of the follow-up period, the survival rate among patients without anemia reached 50.2%, whereas among patients with anemia it was 0.0%.Conclusion. Anemia is an independent predictor of complications in the postoperative period in patients with low preoperative hemoglobin levels. According to the results, the presence of anemia increases the risk of adverse events by 7.71 times in the preoperative period. Moreover, patients without anemia had the highest (up to 50.2%) survival rate in the long-term period, while patients with anemia had a survival rate equal to 0.0%.

Symptomatic tricuspid valve diseases are associated with a high risk of heart failure and poor prognosis. The current valve substitutes still carry the risk of associated complications. Allografts have been considered a valuable surgical option for decades since the first reports were introduced. The challenging surgical technique along with controversial results and homograft shortage discourage surgical society from wider use of allografts in tricuspid surgery. The largest world surgical experience with mitral allograft in the treatment of tricuspid valve disease is described in the study. A total of 20 patients underwent tricuspid valve replacement by mitral homograft in two clinics from October 2021 to February 2023. Surgical technique and initial results are presented in the chapter. There was no early mortality, postoperative bleeding, myocardium infarction, stroke, or sternal wound infection. Two patients needed permanent pacemaker implantation after redoing surgery before discharge. In the follow-up period, two patients suffered from a relapse of infective endocarditis in 3 and 6 months postoperatively with moderate homograft dysfunction, none of them underwent reintervention. There was no late mortality or permanent pacemaker implantation in the follow-up period. Satisfactory clinical and hemodynamic results, reproduceable technique and accessibility make homografts plausible valve substitutes in tricuspid surgery.

Introduction Severe tricuspid regurgitation is associated with the progression of heart failure symptoms and poor survival. Surgical treatment of infective and prosthetic tricuspid valve endocarditis using homografts gives promising early and midterm results. Tricuspid valve replacement with a mitral homograft is a reasonable procedure with a challenging technique. Material and Methods A total of 15 patients underwent tricuspid valve replacement by mitral homograft in two departments from October 2020 to May 2022. The mean age was 36 [31–40.5]. In this article, we describe our original step‐by‐step technique and initial experience of successful use of native or cryopreserved mitral homografts for surgical treatment of tricuspid valve disease. Results There were no in‐hospital and 30‐day mortality, no postoperative bleeding, myocardium infarction, stroke, or sternal wound infection. Only one patient required permanent pacemaker implantation after redo surgery before discharge. The predischarge echocardiogram showed no residual tricuspid regurgitation (TR) in 14 cases (93.3%) and mild TR in 1 (6.7%) patient. All patients were discharged from the hospital without symptoms of endocarditis, with negative blood culture samples. Conclusion Satisfactory initial clinical and hemodynamic results were achieved utilizing our technique. Mid‐ and long‐term results are required to understand the place of homografts in tricuspid valve surgery.

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HighlightsThe article presents the latest data on the techniques of implantation of the mitral homograft in the tricuspid position, and identifies groups of patients who are best suited for this method. Moreover, the article describes the evolution of this type of replacement, and highlights that many surgical techniques, although justified, require further study to show demonstrate their advantages. AbstractDespite the general trend in cardiac surgery towards valve-preserving interventions, valve replacements remain relevant, and the search for the perfect prosthetic valve continues. Many believe that tricuspid valve replacement using a mitral homograft can be the method of choice in certain situations. The analysis of the studies found in the PubMed database led the authors to the following conclusions: most of the data on the use of this technique in patients with infective endocarditis (IE), other indications are congenital heart disease (CHD) and rheumatic heart disease. Patients with IE who have undergone tricuspid valve replacement using a mitral homograft have good medium-term prospects, and respond well to medical treatment of recurrent IE. The mitral homograft in the tricuspid position remains intact even after prosthetic endocarditis. In this regard, it is possible to perform reconstructive intervention in case of prosthetic valve dysfunction without the need for repeated replacement. Such interventions are relevant for patients with growing heart for whom annuloplasty at the first stage of surgery is undesirable. Moreover, it is also cost-effective due to the high cost and low availability of homografts. The possibility of repeated tricuspid valve-in-valve replacement is important for patients who may not survive open surgery. To date, there are not enough long-term and short-term data on using a mitral homograft for tricuspid valve replacement, however, it can be assumed that the results of this technique will be positive provided that the appropriate implantation technique and strict patient selection are ensured. Many authors have come to the conclusion that the optimal homograft implantation technique includes sewing of the graft`s papillary muscles into the wall of the myocardium of the right ventricle (RV), fixating them on the outer surface of the RV, anatomical positioning of the homograft (anterior leaflet faces towards the IVS), and the use of an annuloplasty ring.