Original articleCardiovascularMidterm Outcomes of Tricuspid Valve Repair Versus Replacement for Organic Tricuspid Disease
Section snippets
Patients and Methods
Approval was attained from our institution’s research ethics board to review our prospective database and attain follow-up clinical notes and echocardiograms (waiving the need for individual consent of each patient or relative).
We performed a retrospective review of 250 patients who underwent surgery for organic TV disease between 1979 and 2003 at the Toronto General Hospital. Table 1 lists their pathologies, which included rheumatic, congenital (eg, Ebstein’s, atrioventricular septal defect),
Preoperative and Operative Characteristics
Table 1 shows the preoperative and intraoperative characteristics of the 250 patients who underwent either repair (n = 178) or replacement (n = 72) surgery for documented organic (nonsecondary) disease. The two groups were similar in most aspects, including era of operation. However, the repair group was more likely to have systemic hypertension, more likely to have rheumatic TV pathology, and less likely to undergo isolated TV surgery. The repair group was also less likely to be in
Comment
Organic TV disease is valvular dysfunction due to a primary structural pathology of the tricuspid valve, and not secondary to other valvular or cardiac disease. It is an uncommon clinical entity and therefore there is limited experience from any one center and a paucity of studies to elucidate the optimal surgical technique. To the best of our knowledge, there have not been any series comparing TV repair versus replacement for organic TV disease since the 1970s [6].
Tricuspid valve repair
References (16)
- et al.
Tricuspid valve replacement: UK heart valve registry mid-term results comparing mechanical and biological prostheses
Ann Thorac Surg
(1998) - et al.
Impact of tricuspid regurgitation on long-term survival
J Am Coll Cardiol
(2004) - et al.
Guidelines for reporting morbidity and mortality after cardiac valvular operations
J Thorac Cardiovasc Surg
(1996) - et al.
Tricuspid regurgitation: a comparison of nonoperative management, tricuspid annuloplasty, and tricuspid valve replacement
J Thorac Cardiovasc Surg
(1976) - et al.
Carpentier’s flexible ring versus De Vega’s annuloplasty: a prospective randomized study
J Thorac Cardiovasc Surg
(1985) - et al.
Tricuspid valve repair: durability and risk factors for failure
J Thorac Cardiovasc Surg
(2004) - et al.
Long-term outcomes of tricuspid valve replacement in the current era
Ann Thorac Surg
(2005) - et al.
Biological or mechanical prostheses in tricuspid position?a meta-analysis of intra-institutional results
Ann Thorac Surg
(2004)
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Prosthesis choice for tricuspid valve replacement: Comparison of clinical and echocardiographic outcomes
2024, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :In a small cohort study including 27 patients undergoing TVR, the authors identified significant decrease in RV volumes along with a decline in RV ejection fraction immediately after surgery.26 In their evaluation of mid-term outcomes of tricuspid valve surgery, Singh and colleagues27 speculated that TVR is associated with low cardiac output and increased RV dysfunction due to a rigid prosthesis in the TV position which may contribute to increased mortality. In contrast, a study evaluating hemodynamic effects of surgical correction for severe functional TR in 31 patients showed marked reduction in RV volumes with preservation of ejection fraction using cardiac magnetic resonance imaging over a median follow-up of 27 months.28
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