Reoperation for isolated rheumatic tricuspid regurgitation

Moutakiallah, Younes; Aithoussa, Mahdi; Atmani, Noureddine; Seghrouchni, Aniss; Moujahid, A. Al; Hatim, A.; Asfalou, Iliyasse; Lakhal, Zouhair; Boulahya, A.

doi:10.1186/s13019-018-0793-7

Cited by 15 publications

(13 citation statements)

References 11 publications

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“…TVR was the main measure for patients with severe TR after previous tricuspid valve repair and secondary severe TR with left heart valve disease [Guenther 2008;Mao 2016]. However, as the surgical expertise of TVR has rapidly improved in recent years, the mortality has dropped dramatically [Park 2009;Moutakiallah 2018]. In our study, the hospital mortality rate was 16.8% (N = 18), which fell in between the values in the above-mentioned studies.…”

Section: Discussionsupporting

confidence: 44%

The Risk and Outcomes of Reoperative Tricuspid Valve Replacement Surgery

Chen

et al. 2020

HSF

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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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Section: Discussionsupporting

confidence: 44%

The Risk and Outcomes of Reoperative Tricuspid Valve Replacement Surgery

Chen

et al. 2020

HSF

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“…A total of 811 entries were obtained from the literature search, and figure 1 summarises the studies disposition. After abstract screening, 54 full-text studies were evaluated before arriving at the final 16 studies that met the inclusion criteria of this meta-analysis 6–21Table 1. lists the main characteristics of the included studies, totalling 6808 isolated tricuspid valve repairs and 8261 isolated tricuspid valve replacement patients.…”

Section: Resultsmentioning

confidence: 99%

Isolated surgical tricuspid repair versus replacement: meta-analysis of 15 069 patients

et al. 2020

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ObjectivesTricuspid valve disease is increasingly encountered, but surgery is rarely performed in isolation, in part because of a reported higher operative risk than other single-valve operations. Although guidelines recommend valve repair, there is sparse literature for the optimal surgical approach in isolated tricuspid valve disease. We performed a meta-analysis examining outcomes of isolated tricuspid valve repair versus replacement.MethodsWe searched Pubmed, Embase, Scopus and Cochrane from January 1980 to June 2019 for studies reporting outcomes of both isolated tricuspid valve repair and replacement, excluding congenital tricuspid aetiologies. Data were extracted and pooled using random-effects models and Review Manager 5.3 software.ResultsThere were 811 article abstracts screened, from which 52 full-text articles reviewed and 16 studies included, totalling 6808 repairs and 8261 replacements. Mean age ranged from 36 to 68 years and females made up 24%–92% of these studies. Pooled operative mortality rates and odds ratios (95% confidence intervals) for isolated tricuspid repair and replacement surgery were 8.4% vs 9.9%, 0.80 (0.64 to 1.00). Tricuspid repair was also associated with lower in-hospital acute renal failure 12.4% vs 15.6%, 0.82 (0.72 to 0.93) and pacemaker implantation 9.4% vs 21.0%, 0.37 (0.24 to 0.58), but higher stroke rate 1.5% vs 0.9%, 1.63 (1.10 to 2.41). There were no differences in rates of prolonged ventilation, mediastinitis, return to operating room or late mortality.ConclusionIsolated tricuspid valve repair was associated with significantly reduced in-hospital mortality, renal failure and pacemaker implantation compared with replacement and is therefore recommended where feasible for isolated tricuspid valve disease, although its higher stroke rate warrants further research.

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“…Only two of their patients were performed using MITS technique. They have reported renal failure incidence of 30.8% (52). In their comparative study, Maimaiti and colleagues reported a higher risk of acute kidney injury (AKI) in their sternotomy group reaching 35% compared to 13% in the MITS group (32).…”

Section: Renal Complicationsmentioning

confidence: 98%

“…Joseph showed median post-operative hospital stay of 7 days in their MITS patients (28). Regarding median sternotomy tricuspid surgery, Moutakiallah and colleagues reported the hospital stay of 16.9±10.1 days in their 26 patients (only two patients were performed with MITS) (52).…”

Section: Hospital Stay and Cost Effectivenessmentioning

confidence: 99%

Minimally invasive tricuspid valve surgery

Abdelbar¹,

Kenawy²,

Zacharias³

2021

J Thorac Dis

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Tricuspid valve disease carries a very unfavorable prognosis when medically treated. Despite that, surgical intervention is still underperformed for tricuspid valve disease due to the reported high morbidity and mortality from a sternotomy approach. This had led to a shift towards maximizing medical therapy for right ventricular failure and, as a result, a more significant delay in surgical referrals with surgical risks when patients are finally referred. Tricuspid valve patients usually have other co-morbidities resulting from their systemic venous congestion and low flow cardiac output. Minimally invasive tricuspid valve surgery provides less tissue injury and, as a result, less trauma during surgery. This provides a hope for both patients and treating doctors to be more open for providing this procedure with less complications. Isolated minimally invasive tricuspid valve surgery is still not performed as widely as expected. This can be partly due to the adverse outcomes historically labelled to tricuspid valve surgery or by the long journey of learning the surgical team would need to commit to with a minimal access approach. In this article we will review the perioperative pathway, and outcomes of isolated minimally invasive tricuspid valve surgery in the available English literature.

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Reoperation for isolated rheumatic tricuspid regurgitation

Cited by 15 publications

References 11 publications

The Risk and Outcomes of Reoperative Tricuspid Valve Replacement Surgery

The Risk and Outcomes of Reoperative Tricuspid Valve Replacement Surgery

Isolated surgical tricuspid repair versus replacement: meta-analysis of 15 069 patients

Minimally invasive tricuspid valve surgery

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