Surgical results of reoperative tricuspid surgery: analysis from the Japan Cardiovascular Surgery Database

Umehara, Nobuhiro; Matsubara, Hiroaki; Motomura, Noboru; Saito, Satoshi; Yamazaki, Kenji

doi:10.1093/icvts/ivu064

Cited by 12 publications

(5 citation statements)

References 16 publications

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“…We agree with Pfannmuller's opinion, and we also routinely use biological prostheses, regardless of a patient's age, even in patients with a previously implanted mechanical valve (regardless of whether it is in the aortic or mitral position, or both) to avoid trouble due to endocardial temporary pacing lead implantation and excessive anticoagulation mandatory for a mechanical prosthesis in a tricuspid position [25]. While some researchers reported that tricuspid valve replacement was always associated with significantly higher mortality [1,16], others found no statistically significant differences in early and late outcomes between the isolated tricuspid valve repair and replacement surgeries [6]. However, one study reported a reduced mortality with the replacement surgery, which is in accordance with our results [3].…”

Section: Discussionsupporting

confidence: 68%

“…Tricuspid valve disease has always been considered less clinically important than mitral and aortic valve pathology, and its optimal timing for surgical intervention remains controversial [1]. Many patients undergo concomitant tricuspid valve surgery at the time of mitral or aortic valve intervention, while isolated tricuspid valve surgery is rarely performed [2].…”

Section: Introductionmentioning

confidence: 99%

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Simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery

Song

Yao

et al. 2020

J Cardiothorac Surg

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Background: Redo isolated tricuspid valve surgery is associated with a high morbidity and mortality, and its optimal timing remains controversial. Hence, here we reviewed the early and midterm results of simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery in patients at high risk. Methods: A total of 32 consecutive patients underwent a redo isolated tricuspid valve surgery using minimally invasive, beating-heart technique through a right lateral thoracotomy in our center between June 2016 and April 2020. The mean age of patients was 57.4 ± 8.3 years, and 18 patients (56.3%) were women. The mean preoperative EuroSCORE was 7.8 ± 1.4 (range: 6-11). Follow-up was 87.1% complete, with a mean duration of 26.3 ± 12.3 months. Results: Both in-hospital and 30-day mortalities were 3.1%. Tricuspid valve replacement with bioprosthesis was performed in 30 patients (93.8%), and the remaining two patients (6.2%) underwent tricuspid repair (annuloplasty and leaflet reconstruction). The mean cardiopulmonary bypass time was 81.5 ± 29.0 min. The overall in-hospital duration and intensive care unit (ICU) times were 13.6 ± 7.6 days and 4.1 ± 2.8 days, respectively. Postoperative complications included prolonged ventilation in six patients (18.8%), acute kidney injury in three patients (9.4%), and neurologic event, wound infection, or permanent third-degree atrioventricular block, in one patient (3.1%) each. A total of 96.9% patients were discharged uneventfully. Four patients were lost to follow-up; there were no midterm deaths in patients who were followed up. Conclusions: Simplified, minimally invasive, beating-heart technique for redo tricuspid valve surgery is both feasible and safe, and the early and midterm results are excellent.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery

Song

Yao

et al. 2020

J Cardiothorac Surg

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“…According to guidelines and other series 1,43 our analysis showed that age, mycotic TVIE, IVDU, reoperation for an infected prosthetic valve, and presence of right intracardiac device are negative predictors of an unfavorable outcome.…”

Section: Discussionmentioning

confidence: 77%

Similar outcome of tricuspid valve repair and replacement for isolated tricuspid infective endocarditis

Mauro

Bonalumi

Giambuzzi

et al. 2022

Journal of Cardiovascular Medicine

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Aims To compare early and late mortality of acute isolated tricuspid valve infective endocarditis (TVIE) treated with valve repair or replacement.Methods Patients who were surgically treated for TVIE from 1983 to 2018 were retrieved from the Italian Registry for Surgical Treatment of Valve and Prosthesis Infective Endocarditis. All the patients were followed up by means of phone interview or calling patient referral physicians or cardiologists. Kaplan-Meier method was used to assess late survival and survival free from TVIE recurrence with logrank test for univariate comparison. The primary end points were early mortality (30 days after surgery) and long-term survival free from TVIE recurrence.Results A total of 4084 patients were included in the registry. Among them, 149 patients were included in the study. Overall, 77 (51.7%) underwent TV repair and 72 (48.3%) TV replacement. Early mortality was 9% (13 patients). Expected early mortality according to EndoSCORE was 12%. The TV repair showed lower mortality and major complication rate (7% and 16%), compared with TV replacement (11% and 25%), but statistical significance was not reached. Median follow-up was 19.1 years (14.3-23.8). Late deaths were 30 and IE recurrences were 5. No difference in cardiac survival free from IE was found between the two groups after 20 years (80 W 6% Repair Group vs 59 W 13% Replacement Group, P U 0.3). ConclusionsOverall results indicate that once surgically addressed, TVIE has a low recurrence rate and excellent survival, apparently regardless of the type of surgery used to treat it.

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“…Pfannmuller's opinion, and we also routinely use biological prostheses regardless of patient age, even in patients with a previously implanted mechanical valve (regardless of whether it is in an aortic or mitral position, or both) to avoid trouble for endocardial temporary pacing lead implantation and excessive anticoagulation, which is mandatory with a mechanical prosthesis in a tricuspid position [25]. Some researchers reported tricuspid valve replacement was always associated with significant higher mortality [1,16]. Some researchers reported there were no statistical differences in early and late outcomes between the isolated tricuspid valve repair versus replacement surgery [6].…”

Section: Discussionmentioning

confidence: 99%

“…Tricuspid valvular disease has been always considered less clinically important than mitral and aortic valves pathology, and its optimal timing of surgical intervention remains controversial [1]. Many patients undergo concomitant tricuspid valve surgery at the time of mitral or aortic valve intervention, while isolated tricuspid valve surgery is rarely performed [2].…”

Section: Introductionmentioning

confidence: 99%

Simplified Minimally Invasive Beating Heart Technique for Redo Isolated Tricuspid Valve Surgery

Song

Yao

et al. 2020

Preprint

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BackgroundRedo isolated tricuspid valve surgery has been associated with a high morbidity and mortality, and its optimal timing of surgical intervention remains controversial. Hence, we reviewed our early and midterm results with a simplified minimally invasive beating heart technique for isolated redo tricuspid valve surgery in patients at high risk.MethodsBetween June 2016 and August 2017, a total of 14 consecutive patients underwent isolated tricuspid valve operations after previous cardiac operations with minimally invasive beating heart technique through a right lateral thoracotomy in our center. Mean patient age was 54.0 ± 8.3 years, and 9 patients (64.3%) were women. Mean preoperative EuroSCORE was 8.1 ± 1.3 (6 to 11). Previous cardiac operations included 6 patients (42.9%) with mitral valve replacement, 1 patient (7.1%) with mitral valve replacement and tricuspid valve repair, 1 patient (7.1%) with tricuspid valve replacement, 5 patients (35.7%) with mitral valve and aortic valve replacement, and 1 patient (7.1%) with Ebstein repair. Midterm follow-up was complete for 12 patients (85.7%).ResultsBoth in-hospital and thirty-day mortalities were 0%. Tricuspid valve replacement with bioprosthesis was performed in 12 patients (85.7%), and the remaining 2 patients (14.3%) underwent tricuspid repair (annuloplasty and leaflets reconstruction). Mean cardiopulmonary bypass time was 55.6 ± 10.7 minutes. Overall in-hospital duration and intensive care unit (ICU) time were 11.6 ± 8.8 days, 3.9 ± 2.8 days, respectively. Postoperative complications included 2 patients (1.4%) with prolonged ventilation, and 2 patients (1.4%) with acute kidney injury. There were no postoperative cerebrovascular accidents, myocardial infarctions, reoperations for bleeding, or deep wound infections. All patients were discharged uneventful. Except 2 patients lost follow-up, there were no adverse cardiovascular events and deaths occurred in other patients.ConclusionsSimplified minimally invasive beating heart technique for redo tricuspid valve surgery is both feasible and safe, and the early and midterm results are excellent.

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Surgical results of reoperative tricuspid surgery: analysis from the Japan Cardiovascular Surgery Database

Cited by 12 publications

References 16 publications

Simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery

Simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery

Similar outcome of tricuspid valve repair and replacement for isolated tricuspid infective endocarditis

Simplified Minimally Invasive Beating Heart Technique for Redo Isolated Tricuspid Valve Surgery

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