Right heart failure and patient selection for isolated tricuspid valve surgery

Elgharably, Haytham; Ibrahim, Ahmed; Rosinski, Bradley; Thuita, Lucy; Blackstone, Eugene H.; Collier, Patrick; Pettersson, Gösta

doi:10.1016/j.jtcvs.2021.10.059

Cited by 7 publications

(2 citation statements)

References 35 publications

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“…Our search identified 7 eligible studies, including 1 case report and 6 retrospective observational studies, that enrolled a total of 2,202 patients with isolated TV surgery for functional TR. [17][18][19][20][21][22][23] A study characteristics table is presented in ►Supplementary Table S1 (available in the online version).…”

Section: Study Selectionmentioning

confidence: 99%

Isolated Tricuspid Valve Surgery for Functional Tricuspid Regurgitation

Kaneyuki,

Jordan,

Rosen

et al. 2024

Thorac Cardiovasc Surg

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Background: Severe tricuspid regurgitation (TR) adversely affects long-term survival; however, isolated tricuspid valve (TV) surgery has been rarely performed due to high operative mortality. In addition, the previous literature included heterogeneous TR etiologies. Therefore, we aimed to elucidate early and long-term outcomes of isolated TV surgery for functional TR. Methods: An electronic search was performed to identify all relevant studies. Baseline characteristics, perioperative variables, and clinical outcomes were extracted and pooled for meta-analysis. Results: This meta-analysis included seven studies. Pooled analyses showed that 68% (35, 89) of patients had preoperative atrial fibrillation or flutter, and 58% (11, 94) had a history of left-sided valve surgery. Seventy-three percent (65, 80) of patients had at least one physical exam finding of right-sided heart failure, and 57% (44, 69) were in New York Heart Association class III or IV. TV replacement was more common than repair. In TV replacement, bioprosthetic valve (39%, 13, 74) was more common than mechanical prosthesis (22%, 18, 26). The early mortality rate was 7%. Twenty percent of patients required a permanent pacemaker postoperatively. The overall 1- and 5-year survival rates were 84.5% and 69.1%, respectively. Conclusion: More than half of the patients who underwent isolated TV surgery for functional TR had undergone left-sided valve surgery and had significant heart failure symptoms at the time of surgery. Further studies on the surgical indication for concomitant TV surgery at the time of left-sided valve surgery and the appropriate timing of surgery for isolated functional TR are needed to improve survival.

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Section: Study Selectionmentioning

confidence: 99%

Isolated Tricuspid Valve Surgery for Functional Tricuspid Regurgitation

Kaneyuki,

Jordan,

Rosen

et al. 2024

Thorac Cardiovasc Surg

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“…Patients Perspective Chapter: Right Ventricular Free Wall -The Forgotten Territory for Revascularization DOI: http://dx.doi.org/10.5772/intechopen.114819 presenting for surgery for isolated tricuspid regurgitation, especially in the setting of reoperation after previous CABG, are often considered high-risk and likely will not be offered another surgery. This could be related to the high mortality rates reported among different groups [35]. These patients commonly present with clinical right heart failure manifestations secondary to RV dysfunction, including liver congestion, renal dysfunction, thrombocytopenia, and volume overload, which adds to the risk of the operation in addition to the technical aspects of re-operation after CABG with patent grafts.…”

Section: Reoperation For Isolated Tricuspid Regurgitationmentioning

confidence: 99%

Perspective Chapter: Right Ventricular Free Wall – The Forgotten Territory for Revascularization

Elgharably,

C. Harb,

Mentias

et al. 2024

Cardiology and Cardiovascular Medicine

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Revascularization of the right ventricle free wall is not routinely addressed during coronary bypass surgery, yet the clinical impact is not well studied. Addressing right ventricular free wall ischemia is feasible via bypassing branches of the right coronary artery. In this article, we aim to examine the hypothesis that ignoring the right ventricular free wall ischemia during coronary artery bypass surgery could have an early, and possibly late, clinical impact, such as right ventricular dysfunction and functional tricuspid regurgitation, in patients with extended right coronary artery disease without adequate collateralization from the left coronary system. We present the current available evidence that is relevant to that hypothesis.

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Tricuspid Regurgitation and Right Heart Failure

Agarwal

Hahn

2023

Heart Failure Clinics

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Right heart failure and patient selection for isolated tricuspid valve surgery

Cited by 7 publications

References 35 publications

Isolated Tricuspid Valve Surgery for Functional Tricuspid Regurgitation

Isolated Tricuspid Valve Surgery for Functional Tricuspid Regurgitation

Perspective Chapter: Right Ventricular Free Wall – The Forgotten Territory for Revascularization

Tricuspid Regurgitation and Right Heart Failure

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