Tricuspid valve repair in isolated tricuspid pathology: a 12-year single center experience
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(2020) 15:330
RESEARCH ARTICLE
Open Access
Tricuspid valve repair in isolated tricuspid pathology: a 12-year single center experience Alina Zubarevich1* , Marcin Szczechowicz2, Andreas Brcic3, Anja Osswald1, Konstantinos Tsagakis1, Daniel Wendt1, Bastian Schmack1, Michel Pompeu B. O. Sá4, Jef Van den Eynde5, Arjang Ruhparwar1 and Konstantin Zhigalov1
Abstract Objectives: Long-term data on isolated surgical tricuspid valve procedures is limited. Current guidelines on heart valve disease recommend valve repair over valve replacement. In this study we report our 12-year single-center experience with isolated surgical tricuspid valve repair in patients with various tricuspid valve pathologies. Methods: Between May 2007 and December 2019, 26 consecutive patients underwent isolated tricuspid valve annuloplasty/repair for various indications. In 18 patients (69.2%) an open ring or band annuloplasty (26.9 and 42.3%, respectively) was performed, 5 patients (19.2%) underwent a tightening of the annulus using the DeVega technique, 5 patients (19.2%) had a leaflet reconstruction with patch or bicuspidalization and in 3 patients (11.5%) a leaflet debridement was performed. In 15.4% of the cohort a combination of the techniques was utilized. Results: The mean follow-up time was 2.1 (0.3–5.0) years. Early survival at 30 days after surgery was 84.6%. Mean hospital stay was 11 (6.7–16) days. One-year survival was 73%. No patient required a redo procedure on the tricuspid valve during follow-up. Conclusion: Tricuspid valve repair is suggested as a treatment of choice according to recent guidelines on heart valve disease. If chosen correctly, various repair techniques provide good long-term results. Tricuspid valve repair may be safely applied in patients undergoing surgical isolated tricuspid valve procedures. Keywords: Tricuspid valve, Tricuspid valve regurgitation, Isolated tricuspid valve pathology
Introduction Tricuspid regurgitation (TR) often has a secondary nature, resulting from volume or pressure overload in the presence of right ventricular (RV) failure and annular dilatation with structurally normal leaflets [1]. The most common causes of primary TR are infective endocarditis, mechanical damage by pacemaker wires, rheumatic heart disease, Ebstein anomaly, and drug abuseinduced tricuspid valve endocarditis. Indication and * Correspondence: [email protected] 1 Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany Full list of author information is available at the end of the article
timing of surgical intervention remains controversial due to the limited availability of data on isolated tricuspid valve procedures. Current guidelines suggest that surgery should be carried out as early as onset of signs of RV dysfunction [2]. Valve repair should be preferred over valve replacement for secondary TR, based on the surgeon’s experience, specifics of the valve pathology, and the patient’s condition. Valve replacement should be restricte
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