Tricuspid Valve Detachment in Ventricular Septal Defect Closure Does Not Impact Valve Function

Fraser, Charles D.; Zhou, Xun; Palepu, Sandeep; Lui, Cecillia; Suarez‐Pierre, Alejandro; Crawford, Todd C.; Magruder, J. Trent; Jacobs, Marshall L.; Cameron, Duke E.; Hibino, Narutoshi

doi:10.1016/j.athoracsur.2018.02.075

Cited by 15 publications

(13 citation statements)

References 7 publications

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“…In the advancing years, further variants TVD consisting of septal leaflet detachment have also been described in the pediatric literature (8)(9)(10). Moreover, circumferential detachment of the septal or anterior leaflets, longitudinal incision of the septal leaflet, subvalvular tricuspid apparatus detachment (chordae papillary muscle or both) from septum have all been described in prior reports examining the tricuspid valve dysfunction at short term follow up (11).…”

Section: Discussionmentioning

confidence: 92%

“…Recent studies indicate different results. Fraser et al (11) and Pourmoghadam et al (14) measured a significant increment in both CPB time and X-clamping time. On the other side, Gaynor et al (9) and Russell et al (10) reported no differences between TVD or non-TVD performed groups.…”

Section: Discussionmentioning

confidence: 95%

“…In a meta-analysis including 1014 patients from 14 studies except 4 patients, there was no TR more than mild degree (12). Moreover, regarding to their long term follow up results (mean 2343 days) including 164 patients, Fraser et al (11) suggest that TVD did not compromise long-term valve durability however, did not impose increased morbidity. Within a smaller sample size, Lucchese et al (16) confirmed the aforementioned outcomes in their study consisting of 68 patients with a mean 5.9 years follow-up.…”

Section: Discussionmentioning

confidence: 95%

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Success of Tricuspid Valve Detachment for Ventricular Septal Defect Closure: An Assessment of Midterm Tricuspid Valve Function

Bilen¹,

Akkaya²,

Tuncer³

et al. 2019

J Basic Clin Health Sci

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Introduction: Ventricular septal defect (VSD) is the most common congenital heart anomaly. In surgical treatment, the transatrial approach is frequently utilized because of causing less right bundle block and ventricular scarring. However, some VSDs are obscured by the chordae tendineae or a pouch formation of the septal leaflet; therefore, alternative techniques are required. In such cases, tricuspid valve detachment (TVD) provides a complete visualization and ease to access to ventricular septal defects. In this study, we evaluated the results of the patients of whom we performed TVD. Patient and Method: Our study includes 50 patients who underwent TVD during the procedure with the diagnosis of perimembranous VSD. Patients were examined by transthoracic echocardiography (TTE) before and after operation and the valvular functions are evaluated. All patients were kept in follow up for 3 months after discharge. Results: The mean age of the patients was 27.56±34.81 months. At the end of the study, all patients were in New York Heart Association class I. There was no residual shunt through VSD. Except 4 patients with mild tricuspid regurgation (TR), the TTE has not revealed any TR in majority of patients. Conclusion: We suggest that, in appropriate patients, VSD closure can be performed safely with a TVD application thru an incision of the septal leaflet of the tricuspid valve without any adverse effect on function or growth at of the valve at midterm follow-up.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

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Success of Tricuspid Valve Detachment for Ventricular Septal Defect Closure: An Assessment of Midterm Tricuspid Valve Function

Bilen¹,

Akkaya²,

Tuncer³

et al. 2019

J Basic Clin Health Sci

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“…Conventionally, open-heart surgical repair through midline sternotomy and cardiopulmonary bypass (CPB) is the primary approach for many years (7) . Surgical VSD closure commonly performed through the right atrial approach in which the VSD is reached through the tricuspid valve (8) . The interventricular septum is typically closed by using an autologous pericardium patch, which is fixed by either interrupted or continuous suturing techniques depending on the surgeon preference (9) .…”

Section: Introductionmentioning

confidence: 99%

Interrupted versus Continuous Suture Technique for Ventricular Septal Defects Surgical Closure

Soliman

Salim²,

Baangood³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Ventricular septal defect (VSD) is the most frequent congenital cardiac defect. Conventionally, openheart surgical repair through cardiopulmonary bypass (CPB) is the primary approach for many years. Objective: Given the absence of a reliable evidence on the optimal suture technique regarding the efficacy and morbidity, this study aimed to compare the postoperative complication rates and the outcomes of the interrupted and continuous suture techniques for the surgical VSD closure. Patients and Methods: This retrospective cohort study included 140 consecutive children who underwent surgical closure of congenital VSD of any type with or without associated congenital heart diseases. Patients with associated major cardiac anomalies were excluded. Preoperative, operative, and long-term outcomes data including VSD residual and heart block that needed permanent pacemaker (PPM) were collected from medical files. The closure was performed using interrupted sutures in 76 (54.3%, group 1), and by continuous sutures in 74 (45.7%, group 2) patients. Results: Three (3.9%) patients in group 1 and four (6.3%) patients in group 2 developed heart block that needed PPM, with no significant difference (p=0.702). Four (5.3%) patients in group 1 compared with two (3.1%) patients in group 2 had clinically and sizable (by echocardiography) significant residual, with no significant differences between both groups (p=0.688). Conclusion:The present study indicates that interrupted and continuous VSD closure techniques have comparable success and postoperative complication rates. Thus, the optimal suturing technique for VSD closure cannot be standardized, and their predilection depends on the experience and the comfort of the surgeons.

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“…Severe pulmonary arterial hypertension (PAH) may lead to increased risk of morbidity and death in individuals with big ventricular septal defects (VSD) if the VSD is closed. [2] If VSD is moderate to big and non-restrictive, the closure of VSDs is advised before the age of six months to avoid pulmonary vascular disease. Cardiac catheterization is suggested for measuring pulmonary vascular resistance and testing pulmonary vasoreactivity, in particular if the permanent increase in pulmonary vascular resistance is a clinical issue.…”

Section: Introductionmentioning

confidence: 99%

Role of selective pulmonary vasodilators in management of hypertensive ventricular septal defect in pediatrics

Kasab

Rezk

Aglan

et al. 2021

Benha Journal of Applied Sciences

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Background: Septal ventricular defect is an acyanotic heart condition that requires operation. Pulmonary artery pressure is a major determinant in the outcome of surgery Objectives: Evaluation of the usage of antihypertensive pulmonary medicines after surgical closure of septal ventricular hypertension defects. Materials: 60 patients were chosen for primary ventricular septal defect surgical repair. Instances with congenital abnormalities were eliminated rather than PDA or ASD and redo cases. These cases were divided into two groups (each of 30 patients) one with oral sildenafil and the other with no oral sildenafil. Results: The mean pulmonary artery pressure of sildenafil dropped from 66.4 ± 9.1 to 42.5 ± 3.6 mmHg and decreased to 50.2 ± 5.3 mmHg in the control group. Conclusion: Pulmonary antihypertensive medicines have an essential role in reducing pulmonary artery pressure and provide improved surgical outcomes.

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Tricuspid Valve Detachment in Ventricular Septal Defect Closure Does Not Impact Valve Function

Cited by 15 publications

References 7 publications

Success of Tricuspid Valve Detachment for Ventricular Septal Defect Closure: An Assessment of Midterm Tricuspid Valve Function

Success of Tricuspid Valve Detachment for Ventricular Septal Defect Closure: An Assessment of Midterm Tricuspid Valve Function

Interrupted versus Continuous Suture Technique for Ventricular Septal Defects Surgical Closure

Role of selective pulmonary vasodilators in management of hypertensive ventricular septal defect in pediatrics

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