scholarly journals Right ventricle dysfunction assessment for transcatheter tricuspid valve repair: a matter of debate

2021 ◽  
Author(s):  
Alberto Preda ◽  
Francesco Melillo ◽  
Luca Liberale ◽  
Fabrizio Montecucco ◽  
Eustachio Agricola
Keyword(s):  
Right Ventricle ◽  
Tricuspid Valve ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Right Ventricle Dysfunction

Tricuspid Valve Repair for the Poor Right Ventricle: Tricuspid Valve Repair in Patients with Mild-to-Moderate Tricuspid Regurgitation Undergoing Mitral Valve Repair Improves In-Hospital Outcome

2015 ◽  
Vol 65 (08) ◽  
pp. 612-616 ◽  
Author(s):  
Michele Genoni ◽  
Kirk Graves ◽  
Dragan Odavic ◽  
Helen Löblein ◽  
Achim Häussler ◽  
...  
Keyword(s):  
United States ◽  
Mitral Valve ◽  
Blood Transfusion ◽  
Right Ventricle ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Operation Time ◽  
Tricuspid Valve Repair ◽  
Cell Saver ◽  
Valve Repair

Background Tricuspid regurgitation (TR) in patients undergoing surgery for mitral valve (MV) increases morbidity and mortality, especially in case of a poor right ventricle. Does repair of mild-to-moderate insufficiency of the tricuspid valve (TV) in patients undergoing MV surgery lead to a benefit in early postoperative outcome? Methods A total of 22 patients with mild-to-moderate TR underwent MV repair and concomitant TV repair with Tri-Ad (Medtronic ATS Medical Inc., Minneapolis, Minnesota, United States) and Edwards Cosgrove (Edwards Lifesciences Irvine, California, United States) rings. The severity of TR was assessed echocardiographically by using color-Doppler flow images. The tricuspid annular plane systolic excursion (TAPSE) was under 1.7 cm. Additional procedures included coronary artery bypass (n = 9) and maze procedure (n = 15). The following parameters were compared: postoperative and peak dose of noradrenaline (NA), pre/postoperative systolic pulmonary pressure (sPAP), extubation time, operation time, cross-clamp time, cardiopulmonary bypass (CPB) time, pre/postoperative ejection fraction (EF), intensive care unit (ICU)-stay, hospital stay, cell saver blood transfusion, intra/postoperative blood transfusion, and postoperative TR. Results The mean age was 67 ± 14.8 years, 45% were male. Mean EF was 47 ± 16.2%, postoperative 52 ± 12.4%. sPAP was 46 ± 20.1 mm Hg preoperatively, sPAP was 40.6 ± 9.4 mm Hg postoperatively, NA postoperatively was 12 ± 10 μg/min, NA peak was 18 ± 11 μg/min, operation time was 275 ± 92 minutes, CPB was 145 ± 49 minutes, ICU stay was 2.4 ± 2.4 days, hospital stay was 10.8 ± 3.5 days, cell saver blood transfusion was 736 ± 346 mL, intraoperative transfusions were 2.5 ± 1.6. Two patients needed postoperative transfusions. A total of 19 patients were extubated at the 1st postoperative day, 2 patients at the 2nd day, and 1 at the 4th postoperative day. Two patients required a pacemaker. No reintubation, no in-hospital mortality, and one reoperation because of bleeding complications. Conclusion Correction of mild-to-moderate TR at the time of MV repair does maintain TV function and avoid right ventricular dysfunction in the early postoperative period improving the clinical outcome.

OP-202 GLENN OPERATION IN ASSOCIATION WITH TRICUSPID VALVE REPAIR FOR EBSTEIN ANONAMY AND FAILING RIGHT VENTRICLE

2013 ◽  
Vol 163 (3) ◽  
pp. S78-S79
Author(s):  
E. Prifti ◽  
A. Veshti ◽  
A. Baboci ◽  
M. Bonacchi ◽  
G. Giunti ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Tricuspid Valve ◽  
Tricuspid Valve Repair ◽  
Valve Repair

scholarly journals Dynamics of right ventricle contractility after cardiac surgery of tricuspid valve

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Zagatina ◽  
N Zhuravskaya ◽  
G Kim ◽  
R Kappushev ◽  
D Shmatov
Keyword(s):  
Cardiac Surgery ◽  
Right Ventricle ◽  
Tricuspid Valve ◽  
Clinical Status ◽  
Right Atrial ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Funding Sources ◽  
Valve Operation ◽  
Valve Diseases

Abstract Funding Acknowledgements Type of funding sources: None. Background The function of right ventricle (RV) is an independent prognostic factor for patients with valvular heart disease. However, changes in RV function parameters in patients with and without tricuspid valve operations after cardiac surgery are lack known. The aim of the study was to define changes in RV parameters after cardiac surgery in patients with left-sided valve diseases. Methods Fifty-five consecutive patients (33 men, 61 ± 10 years old), who were referred for the repair and/or replacement of left-sided valves, were included in the study. A transthoracic echocardiography assessment before and an average of 109 days (91-114) following the operation was performed. Tricuspid annular plane systolic excursion (TAPSE), fractional area change RV (FAC), strain of the RV free wall (SRV), and right atrial volume were assessed in groups of patients with and without tricuspid valve repair. Results Valve repair for secondary tricuspid regurgitation was performed in nineteen patients undergoing left-sided valve surgery. Thirty-six patients had repair and/or replacement of left-sided valves without a tricuspid valve operation. There was a strong correlation between TAPSE, FAC, and RV strain before the operation (R = 0.62-0.77, p < 0.000002). However, there was no correlation between TAPSE and FAC; TAPSE and RV strain after the operation. TAPSE and RV strain significantly decreased after the operations and were below the normal range in both the groups of patients with and without tricuspid valve repair. TAPSE was 21 ± 5mm before the operation vs. 14 ± 4 mm after operation, p < 0.0000001 for all patients (20 ± 5mm vs. 13 ± 3 mm, p < 0.0003 for the group which underwent tricuspid valve repair; 22 ± 4mm vs. 14 ± 4 mm, p < 0.000001 for tricuspid valves which were not operated on). RV strain was -19 ± 6 mm before operating vs. -16 ± 5mm after operating, p < 0.0004 for all patients (-20 ± 6mm vs. -15 ± 5mm, p < 0.006 for tricuspid valve repair; -19 ± 6mm vs. -16 ± 4 mm, p < 0.02 for the tricuspid valves which were not operated on).  There was no difference in TAPSE and SRV among patients with and without tricuspid valve repair. Decreased longitudinal function parameters (TAPSE and SRV) didn’t correlate with patients’ clinical status or with normalized right chambers volumes. FAC was 39 ± 11% before operating vs. 41 ± 9% after the operation, p = 0.45 for all patients (37 ± 13% vs. 40 ± 8%, p = 0.69 for the group which underwent tricuspid valve repair; 40 ± 10% vs. 41 ± 9%, p = 0.52 for the group with tricuspid valves which were not operated on). An increase in FAC correlated with a decrease in right chamber sizes after operations (R=-0.37, p < 0.03). Conclusion Longitudinal right ventricle parameters (TAPSE, SRV) significantly decrease after valve operations in groups with and without tricuspid valve repair. However, there is no correlation with the clinical status of patients. Global function parameters (FAC) correlates with the normalization of right chamber size after cardiac operation.

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