Surgical management of acquired tricuspid valve disease

Carpentier, A; Deloche, A; Hanania, G; Forman, J; Sellier, P; Piwnica, A; Dubost, C; McGoon, Dwight C.

doi:10.1016/s0022-5223(19)39760-0

Cited by 200 publications

(43 citation statements)

References 11 publications

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“…Generally, the regurgitation depends on annular dilatation and the reduction in the systolic annular constriction [Come 1985]. Similar dilatation is seen in the mural annular segment and particularly in the posterior annulus (80%) [Carpentier 1974]. Isolated tricuspid valve regurgitation is a rare clinical entity.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of De Vega versus Biodegradable Ring Annuloplasty in the Surgical Treatment of Tricuspid Regurgitation (Mid-term Results)

Başel¹,

Ünal²,

Kutlu³

et al. 2010

The Heart Surgery Forum

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Section: Discussionmentioning

confidence: 99%

Outcomes of De Vega versus Biodegradable Ring Annuloplasty in the Surgical Treatment of Tricuspid Regurgitation (Mid-term Results)

Başel¹,

Ünal²,

Kutlu³

et al. 2010

The Heart Surgery Forum

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“…Contrary to mitral valve regurgitation, functional tricuspid regurgitation (TR) is the most common form of TR, and is often associated with left-sided valve disease mainly due to MR (10,25,42). This shows that regardless of the valve type, the ECM characteristics of AV valves' leaflets have a key role in the pathophysiology of these valves.…”

mentioning

confidence: 99%

Load-dependent extracellular matrix organization in atrioventricular heart valves: differences and similarities

Alavi

Sinha

Steward

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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The extracellular matrix of the atrioventricular (AV) valves' leaflets has a key role in the ability of these valves to properly remodel in response to constantly varying physiological loads. While the loading on mitral and tricuspid valves is significantly different, no information is available on how collagen fibers change their orientation in response to these loads. This study delineates the effect of physiological loading on AV valves' leaflets microstructures using Second Harmonic Generation (SHG) microscopy. Fresh natural porcine tricuspid and mitral valves' leaflets (n = 12/valve type) were cut and prepared for the experiments. Histology and immunohistochemistry were performed to compare the microstructural differences between the valves. The specimens were imaged live during the relaxed, loading, and unloading phases using SHG microscopy. The images were analyzed with Fourier decomposition to mathematically seek changes in collagen fiber orientation. Despite the similarities in both AV valves as seen in the histology and immunohistochemistry data, the microstructural arrangement, especially the collagen fiber distribution and orientation in the stress-free condition, were found to be different. Uniaxial loading was dependent on the arrangement of the fibers in their relaxed mode, which led the fibers to reorient in-line with the load throughout the depth of the mitral leaflet but only to reorient in-line with the load in deeper layers of the tricuspid leaflet. Biaxial loading arranged the fibers in between the two principal axes of the stresses independently from their relaxed states. Unlike previous findings, this study concludes that the AV valves' three-dimensional extracellular fiber arrangement is significantly different in their stress-free and uniaxially loaded states; however, fiber rearrangement in response to the biaxial loading remains similar.

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“…7,11 In prosthetic ring annuloplasty, the annulus is permanently fixed in a systolic position, and the physiologic shape of the TV is restored. 12 However, none of these techniques has consistently eliminated functional TR.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Artificial Neochordae Implantation in Tricuspid Valve Repair

Salihi¹,

Kızıltan²,

Huraibat³

et al. 2019

Texas Heart Institute Journal

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Various techniques for treating tricuspid regurgitation have been described; however, because of scarce data about the long-term outcomes of different repairs, the optimal technique has not been established. We evaluated the effectiveness and durability of artificial neochordae implantation in the treatment of tricuspid regurgitation.From 2009 through 2014, 507 patients underwent tricuspid valve repair at our institution. Of those, 48 patients implanted with artificial neochordae were included in our study. The median age of the participants was 62 years (range, 4-77 yr) and 50% were women. Thirty patients (63%) were in New York Heart Association functional class III, and 11 (23%) were in class II. The cause of tricuspid regurgitation was functional in 33 patients (69%) and rheumatic in 15 (31%). In 46 patients, neochordae implantation was performed in addition to Kay annuloplasty (n=13) or ring annuloplasty (n=33).Forty-two patients were discharged from the hospital with absent or mild tricuspid regurgitation. The mean follow-up period was 44.3 ± 20.2 months. Follow-up echocardiograms revealed that tricuspid regurgitation was absent, minimal, or mild in 38 patients (80.8%), moderate in 7, and severe in 2.Our results indicate that the use of artificial neochordae implantation as an adjunct procedure to annuloplasty leads to effective and durable repair in comparison with conventional techniques for treating tricuspid regurgitation. (Tex Heart Inst J 2019;46(2):100-6)

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Surgical management of acquired tricuspid valve disease

Cited by 200 publications

References 11 publications

Outcomes of De Vega versus Biodegradable Ring Annuloplasty in the Surgical Treatment of Tricuspid Regurgitation (Mid-term Results)

Outcomes of De Vega versus Biodegradable Ring Annuloplasty in the Surgical Treatment of Tricuspid Regurgitation (Mid-term Results)

Load-dependent extracellular matrix organization in atrioventricular heart valves: differences and similarities

Effectiveness of Artificial Neochordae Implantation in Tricuspid Valve Repair

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