scholarly journals Surgical Repair versus Conservative Treatment for Moderate Functional Tricuspid Regurgitation in Concomitant with Mitral Valve Surgery

2020 ◽  
Vol 2 (2) ◽  
pp. 70-75
Author(s):  
Moataz Rezk ◽  
Shimaa Moustafa ◽  
Nora Singab ◽  
Ashraf Elnahas
Keyword(s):  
Mitral Valve ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Surgical Repair ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Functional Tricuspid Regurgitation ◽  
Group A ◽  
Group B ◽  
Valve Lesion

Background: Management of moderate functional tricuspid regurgitation (FTR) secondary to left-sided valve lesion is controversial. The objective of this study was to compare the short-term results of surgical repair versus conservative treatment for moderate functional tricuspid regurgitation in concomitant with mitral valve surgery. Methods: Our study included 60 patients with mitral valve lesion and moderate functional tricuspid regurgitation. Patients were divided into 2 groups; group A included 30 patients whose tricuspid valve disease were managed conservatively, and group B included 30 patients who had tricuspid valve band annuloplasty. Results: Preoperative clinical and echocardiographic data were comparable between groups. There was no difference regarding mechanical ventilation time (6 .13 ± 3.02 vs. 7.01 ± 4.14 hours; p= 0.291), or intensive care unit stay (51.42 ± 12.1 vs. 52.31 ± 15.32 hours; p=0.614) in group A and B respectively. There was a significant improvement in the degree of tricuspid valve regurgitation in group B early postoperative (moderate tricuspid regurgitation reported in 22 (73.3%) vs. 4 (13.3%); p<0.001) and at 3 months (moderate tricuspid regurgitation 11 (36.7%) vs. 2 (6.7%); p<0.001) and 6 months follow up (moderate tricuspid regurgitation 10 (30%) vs.  2 (6.7%); p<0.001) in group A and B respectively. After 6-months, 20 (66.7%) patients in group A had dyspnea grade I compared to 26 (86.7%) patients in group B; p=0.021. Conclusion: Although the correction of the left-sided lesion improved the degree of TR in some patients, concomitant repair of the tricuspid valve could produce better improvement in the clinical outcome when compared to the conservative approach.

scholarly journals Video-assisted Minimally Invasive Mitral Valve Surgery versus Conventional Mitral Surgery in Rheumatic Patients

2020 ◽  
Author(s):  
Ayman Badawy ◽  
Mohamed Alaa Nady ◽  
Mohamed Ahmed Khalil Salama Ayyad ◽  
Ahmed Elminshawy
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Invasive Approach ◽  
Video Assisted ◽  
Group A ◽  
Group B

Background: Minimally invasive mitral valve surgery became an attractive option because of its cosmetic advantages over the conventional approach. The superiority of the minimally invasive approach regarding other aspects is still debatable. The aim of our study was to determine the potential benefits of minimally invasive mitral valve replacement with intraoperative video assistance over conventional surgery. Methods: This is a single-center prospective cohort study that included 60 patients with rheumatic heart disease who underwent mitral valve replacement. Patients were divided into two groups: group (A) included patients who had conventional sternotomy (n= 30), and group (B) included patients who had video-assisted minimally invasive mitral valve replacement (n= 30). Intraoperative and postoperative outcomes were compared between both groups. Results: Mortality occurred in one patient in the group (A). Cardiopulmonary bypass time was 118.93 ± 29.84 minutes vs. 64.73 ± 19.16 minutes in group B and A respectively (p< 0.001), and ischemic time was 102.27 ± 30.03 minutes vs. 53.67± 18.46 minutes in group B and A respectively (P < 0.001). Ventilation time was 2.77± 2.27 vs. 6.28 ± 4.48 hours in group B and A respectively (p< 0.001) and blood transfusion was 0.50 ± 0.63 vs. 2.83 ± 1.34 units in group B and A respectively (p< 0.001).  ICU stay was 1.73 ± 0.64 days in the group (B) vs. 4.47 ± 0.94 days in group A (p< 0.001). Postoperative bleeding was 353.33 ± 146.77 ml in the group (B) vs. 841.67 ± 302.03 ml in group A (p <0.001). No conversion to full sternotomy was reported in group B. In group (B), two cases (6.6%) required re-exploration for bleeding vs. four cases (13.2%) in group (A) (p=0.67). The hospital stay was 6.13 ± 1.59 days in the group (B) vs. 13.27 ± 7.62 days in group A (p< 0.001). Four cases (13.3%) developed mediastinitis in group A and in the group (B), there was one case of acute right lower limb embolic ischemia. Conclusion: Video-assisted minimally invasive mitral operations could be a safe alternative to conventional sternotomy with the potential of lesser morbidity and earlier hospital discharge.

Impact of tricuspid ring annuloplasty on functional tricuspid regurgitation after mitral valve surgery

2019 ◽  
Vol 32 (2) ◽  
pp. 587
Author(s):  
HeshamH Ahmed ◽  
AhmedL Dokhan ◽  
MohammedE Abdelraof ◽  
AmrM Allama ◽  
ShahzadG Raja
Keyword(s):  
Mitral Valve ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty

Video-Assisted Minimally Invasive Mitral Valve Surgery External Aortic Clamp versus Endoclamp Techniques

2010 ◽  
Vol 5 (6) ◽  
pp. 413-418 ◽  
Author(s):  
Antonio Loforte ◽  
Giampaolo Luzi ◽  
Andrea Montalto ◽  
Federico Ranocchi ◽  
Vincenzo Polizzi ◽  
...  
Keyword(s):  
New York ◽  
Mitral Valve ◽  
Heart Association ◽  
Mitral Valve Surgery ◽  
Balloon Occlusion ◽  
Valve Surgery ◽  
Aortic Clamping ◽  
Video Assisted ◽  
Group A ◽  
Group B

Objective Video-assisted minimally invasive mitral valve surgery can be performed through different approaches. The aim of the study was to report our early results and compare the external transthoracic aortic clamping with the endoaortic balloon occlusion techniques according to our experience. Methods Between January 2000 and March 2010, 138 patients (103 women, aged 58.4 ± 10.2 years) underwent video-assisted mitral valve surgery through a right thoracotomy. Cardiopulmonary bypass was instituted by femoral arterial and bicaval cannulation with active venous drainage and normothermia; cardioplegic arrest achieved with intermittent blood cardioplegia. In group A (93 patients, 68 women, aged 58.8 ± 7.8 years, 72 MV replacement, 21 MV repair), aortic clamping was achieved using the external transthoracic aortic clamp. In group B (45 patients, 35 women, aged 58.1 ± 11.4 years, 33 MV replacement, 12 MV repair), aortic clamping was achieved with endoaortic balloon occlusion. Results Intraoperative procedure-associated problems were experienced in one patient (0.7%) in group A (one conversion to sternotomy for pleural adhesions and bad exposure). At a mean follow-up of 36 ± 18 months, 135 patients (97.8%) were in New York Heart Association class I to II, with satisfactory echocardiographic follow-up. In group A, two patients had noncardiac-related deaths. No perioperative deaths were observed in both groups. There were four (2.8%) transient ischemic attacks and one (0.7%) peripheral ischemic event (group A) during the early postoperative period. Mitral valve repair patients had a 5-year freedom from reoperation of 100% in both groups. There was no significant difference between the two groups regarding preoperative variables, such as age, sex, New York Heart Association class, and left ventricular ejection fraction (P ≥ 0.05). Postoperative levels of myocardial cytonecrosis enzymes (MB fraction, creatine kinase, and troponine I) as well as operative time, extracorporeal circulation, and aortic cross-clamping times or ventilation and intensive care unit times were not significantly different between the two groups (P ≥ 0.05). More microembolic events were observed in group A than in group B (total 143.4 ± 30.6 per patient vs 78.9 ± 28.6 per patient) by means of continuous automated intraoperative transcranial Doppler evaluations (P < 0.05) applied to part of population. Conclusions Both techniques proved safe and comparable with low risk of morbidity and mortality. Patients undergoing endoclamp technique resulted to be less subject to embolism.

Determinants of recurrent tricuspid regurgitation following tricuspid valve annuloplasty during mitral valve surgery

2017 ◽  
Vol 32 (4) ◽  
pp. 237-244 ◽  
Author(s):  
Hisato Ito ◽  
Toru Mizumoto ◽  
Yasuhiro Sawada ◽  
Kazuya Fujinaga ◽  
Hironori Tempaku ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Valve Annuloplasty

scholarly journals Mild-to-moderate functional tricuspid regurgitation in patients undergoing mitral valve surgery

2013 ◽  
Vol 146 (5) ◽  
pp. 1092-1097 ◽  
Author(s):  
Sun Kyun Ro ◽  
Joon Bum Kim ◽  
Sung Ho Jung ◽  
Suk Jung Choo ◽  
Cheol Hyun Chung ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Functional Tricuspid Regurgitation

scholarly journals Tricuspid regurgitation and right ventricular function after mitral valve surgery with or without concomitant tricuspid valve procedure

2013 ◽  
Vol 146 (5) ◽  
pp. 1126-1132.e10 ◽  
Author(s):  
Ravi R. Desai ◽  
Lina Maria Vargas Abello ◽  
Allan L. Klein ◽  
Thomas H. Marwick ◽  
Richard A. Krasuski ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Right Ventricular Function ◽  
Mitral Valve Surgery ◽  
Valve Surgery

scholarly journals De Vega annuloplasty versus ring annuloplasty for repair of functional tricuspid regurgitation

2018 ◽  
Vol 6 (2) ◽  
pp. 422
Author(s):  
Khaled Alnawaiseh ◽  
Bashar Albkhoor ◽  
Yanal Alnaser ◽  
Hayel Aladwan ◽  
Issa Ghanma
Keyword(s):  
Mitral Valve ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Term Survival ◽  
Free Survival ◽  
Ring Group ◽  
Ring Annuloplasty

Background: Tricuspid insufficiency (TI) is a functional insufficiency in most of the cases and associated with the dilatation of the annulus and remolding. Pulmonary hypertension and right ventricular volume overload due to chronic aortic or / and mitral valve disease in most of the time causes the functional tricuspid insufficiency. Despite the different techniques used to repair the tricuspid valve, the recurrent TR is still occurring in 20- 30 % of the patients and the development of late TR is an important complication of left heart surgery. Our study aims to compare the long-term outcome of ring annuloplasty with De Vega annnuloplasty in patients with secondary tricuspid regurgitation (TR).Methods: A retrospective study of 320 patients who underwent tricuspid valve repair surgery for secondary tricuspid regurgitation from January 2002 to December 2010 at Queen Alia Heart Institute (QAHI). Patients were divided into two groups, in group (1) (n=180) patients had an annuloplasty ring. Group (2) (n=140) patients had De Vega procedure (no ring). The procedures were performed in association with mitral valve surgery in 78% of patients, aortic valve surgery in 15% and combined aortic and mitral valve surgery in 7% of patients. TR grade, NYHA functional class and Pulmonary artery pressure were nearly similar and no significant preoperative difference between the two groups.Results: Echocardiographic and clinical follow up were done for all patients. The duration of procedure for both De Vega and ring annuloplasty were nearly similar. The overall survival in ring group at 5year was 83.9% versus 77.9% in De Vega group. Freedom from residual and recurrent TR, event free survival and long-term survival were significantly better in the ring group and also the tricuspid valve reoperation were less in the ring group.Conclusions: The implantation of annuloplasty ring results in lower incidence of residual or recurrent of tricuspid regurgitation, improved the event-free survival and long-term survival when compared with the sewing techniques such as De Vega.

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