Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25 years of experience

Morimoto, Naoto; Matsushima, Syunsuke; Aoki, Masaya; Henmi, Soichiro; Nishioka, Naritomo; Murakami, Hirohisa; Honda, Tasuku; Nakagiri, Keitaro; Yoshida, Masato; Mukohara, Nobuhiko

doi:10.1007/s11748-012-0190-4

Cited by 17 publications

(9 citation statements)

References 18 publications

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“…A recent report noted 5-and 10-year survival rates after TVR with a bioprosthesis of 63.6±8.9% and 56.5±10.3%, respectively. 22 Freedom from reoperation at 10 years was 100%. 17 In specific cases, such as stenotic valve disease associated with rheumatic change, TVR may be indicated.…”

Section: Disclosuresmentioning

confidence: 98%

Late Outcome of Tricuspid Annuloplasty Using a Flexible Band/Ring for Functional Tricuspid Regurgitation

Fukunaga

Okada

Konishi

et al. 2015

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp plasty ring over suture annuloplasty. 4, 9 We have consistently performed TAP using a flexible ring or band for >10 years.This study assessed late survival and freedom from recurrent or progressive FTR following TAP for FTR. Additionally, the effect of residual TR on late outcome was investigated. MethodsThis retrospective study was approved by the institutional review board. We retrospectively reviewed the medical records of 220 patients (mean age, 65.4±11.4 years; range, 16-83 years) who underwent TAP for FTR in the setting of mitral valve surgery at Kobe City Medical Center General Hospital between January 2000 and December 2010. Of 220 patients, 160 (72.7%) underwent mitral valve repair (MVP), and 60 (27.3%) underwent mitral valve replacement (MVR). Patient preoperative characteristics are listed in Table 1. With regard to mitral etiology, degenerative entities comprised 94% in patients who had MVP, and rheumatic disease accounted for 87% in those unctional tricuspid regurgitation (FTR) mainly occurs because of tricuspid annular dilation and right ventricular enlargement and/or right ventricular dysfunction in mitral valve diseases. 1,2 FTR causes further right ventricular dilatation, dysfunction, or more annular dilatation, subsequently worsening FTR. 1 Increasing severity of FTR is associated with poor survival in healthy men irrespective of left ventricular function or pulmonary hypertension. 3 Despite improved understanding of FTR and its surgical management, reports of late survival associated with FTR are limited. Guenther et al showed that 10-year survival after tricuspid annuloplasty (TAP) was 46%, 4 and Pfannmuller et al showed that 5-year survival was approximately 60%. 5 Persistent FTR after mitral prosthetic replacement is reported to be a risk factor for postoperative congestive heart failure and late mortality. 6 In redo series of mitral valve surgery, persistent FTR had a negative effect on late survival. 7 FTR after TAP in redo valvular surgery also affected late outcome. 8 Evidence supports the superiority of TAP with an annulo- We assessed late outcome after tricuspid annuloplasty (TAP) using a flexible band or ring for functional tricuspid regurgitation (FTR).

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Section: Disclosuresmentioning

confidence: 98%

Late Outcome of Tricuspid Annuloplasty Using a Flexible Band/Ring for Functional Tricuspid Regurgitation

Fukunaga

Okada

Konishi

et al. 2015

Circ J

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“…Recently, several studies supported the prognostic value of the MELD‐XI score in acute and chronic HF . In patients undergoing tricuspid valve replacement, preoperative hepatic congestion indicated by a MELD score > 10 independently predicted long‐term mortality . In the current study, we aim to assess the prognostic value of the MELD‐XI score in patients undergoing PMVR.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of impaired hepato‐renal function assessed by the MELD‐XI score in patients undergoing percutaneous mitral valve repair

Spieker

Hellhammer

Wiora

et al. 2018

Cathet Cardio Intervent

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Objectives The objective of this study was to assess the prognostic value of the Model for End‐stage Liver Disease (MELD)‐XI score in patients undergoing PMVR with the MitraClip system. Background MELD‐XI score, which was originally developed for prognostic assessment in patients with advanced liver disease, has been reported as a predictor of outcome in heart failure patients. Methods A total of 192 consecutive patients undergoing percutaneous mitral valve repair (PMVR) were included into final analysis. MELD‐XI score was calculated on the day of the procedure and patients were categorized into three groups based on MELD‐XI score and compared with regards to clinical characteristics and outcomes following PMVR. Results MELD‐XI > 12 was associated with male gender, higher logistic EuroSCORE, reduced left ventricular ejection fraction, enlarged right ventricular end‐diastolic diameter, degree of mitral regurgitation, increased NT‐proBNP serum levels and elevated right atrial pressures. Youden‐Index revealed a cutoff of 16 in the MELD‐XI score as best predictor of one‐year all‐cause mortality. Kaplan–Meier analysis and the log‐rank test confirmed increased one‐year mortality in patients with critically high score above 16 (mortality MELD‐XI score > 16 vs 16–12 vs <12:39% vs 9%. vs 15%; P = 0.005). Compared to patients with lower MELD‐XI score, these patients exhibited a more than 3‐fold increased one‐year mortality after PMVR. Conclusion Given the high mortality in patients with a MELD‐XI score > 16, these patients require a high‐risk preoperative assessment and should undergo a careful discussion within the heart team for the best treatment option given the considerable one‐year mortality following PMVR.

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“…For patients with combined tricuspid and pulmonary valve disease, tricuspid valve surgery may carry up to 10% mortality risk, [1][2][3][4] and similar outcomes have been reported after multiple valve surgery. 5 The risks of mortality and major morbidity are higher in the setting of redo sternotomy.…”

Section: Introductionmentioning

confidence: 69%

“…13 For those undergoing tricuspid valve replacement as compared to repair, and those undergoing reoperation, the risk of mortality is higher. [2][3][4] All patients included in this series would have been classified as high risk by conventional criteria.…”

Section: Commentmentioning

confidence: 99%

Combined Transcatheter Tricuspid and Pulmonary Valve Replacement

Small

Aksoy

Levi³

et al. 2020

World J Pediatr Congenit Heart Surg

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Background: For patients with combined tricuspid and pulmonary valve disease, operative intervention carries high mortality risk. Published reports of combined transcatheter tricuspid and pulmonary valve replacement have been limited to single cases. Methods: A retrospective chart review was performed including all patients undergoing combined transcatheter tricuspid and pulmonary valve replacement at the Ahmanson/UCLA Adult Congenital Heart Disease Center. Results: Combined transcatheter tricuspid and pulmonary valve replacement was undertaken in five adult patients (median age: 46 years; range: 24-64 years). Three had congenital heart disease and two had carcinoid syndrome. Four patients had previous surgical tricuspid valve replacement and one had a surgical incomplete annuloplasty ring. Four patients had previous surgical pulmonary valve replacement and one had a right ventricle-to-pulmonary artery homograft conduit. Two patients underwent Medtronic Melody valve implantation in both tricuspid and pulmonary positions and three underwent Edwards Sapien S3 implantation in both tricuspid and pulmonary positions. Valve implantation was successful in all. Follow-up ranged from 0.9 to 3.0 years. One patient underwent redo transcatheter tricuspid valve replacement 12 months after the first transcatheter intervention for progressive regurgitation of a Melody valve. This patient died 2.5 years after combined valve placement of complications from refractory heart failure. The remaining patients were alive and free of valve reintervention at follow-up. Conclusions: Combined transcatheter tricuspid and pulmonary valve replacement can be performed successfully, with an acceptable complication rate. This strategy is a feasible option for appropriately selected patients.

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Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25 years of experience

Abstract: Preoperative hepatic congestion and liver dysfunction which were indicated by the MELD score >10 were associated with poor outcome for patients undergoing tricuspid valve replacement. The MELD score is useful to predict the morality among these patients.

Cited by 17 publications

References 18 publications

Late Outcome of Tricuspid Annuloplasty Using a Flexible Band/Ring for Functional Tricuspid Regurgitation

Late Outcome of Tricuspid Annuloplasty Using a Flexible Band/Ring for Functional Tricuspid Regurgitation

Prognostic value of impaired hepato‐renal function assessed by the MELD‐XI score in patients undergoing percutaneous mitral valve repair

Combined Transcatheter Tricuspid and Pulmonary Valve Replacement

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