1,284 results on '"Cardiac Valve Annuloplasty"'
Search Results
2. TRI-REPAIR: TrIcuspid Regurgitation RePAIr With CaRdioband Transcatheter System (TRI-REPAIR)
- Published
- 2021
3. Anuloplastia de De Vega. Cincuenta años desde el comienzo de la reparación valvular selectiva, regulable y permanente
- Author
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José Francisco Valderrama-Marcos
- Subjects
Tricuspid annuloplasty ,De Vega annuloplasty ,Cardiac valve annuloplasty ,Tricuspid valve prolapse ,Tricuspid valve insufficiency ,Tricuspid valve regurgitation ,Medicine ,Surgery ,RD1-811 - Abstract
Resumen: La anuloplastia de De Vega consiste en una doble sutura apoyada en parches de teflón en sus extremos y anudada de tal forma que corrige la regurgitación en la válvula tricúspide. Tras 50 años desde su publicación, se repasan sus antecedentes históricos, la técnica original y las sucesivas modificaciones que han ido surgiendo bajo el mismo concepto fisiopatológico. La anuloplastia de De Vega ha sido empleada extensamente en todo el mundo para corregir la insuficiencia tricúspide, especialmente aquella regurgitación secundaria funcional de forma concomitante a la cirugía de la válvula mitral. También se ha empleado en lesiones traumáticas, trasplante cardiaco o población infantil. En comparación con la anuloplastia con anillo rígido o semirrígido parece conferir menor estabilidad en el tiempo, sin que ello se haya traducido en un aumento de la morbimortalidad o la tasa de reintervenciones. Es una técnica rápida, sencilla, reproducible, económica, segura y que ofrece excelentes resultados clínicos en pacientes seleccionados. Tras 50 años sigue vigente especialmente como tratamiento de la insuficiencia tricúspide funcional no severa en el contexto de una cirugía valvular izquierda sin dilatación significativa del ventrículo derecho. Abstract: De Vega annuloplasty consists of a double suture supported by Teflon patches at its ends and tied in such a way as to correct regurgitation in the tricuspid valve. After 50 years since its publication, its historical background, the original technique and the successive modifications that have emerged under the same pathophysiological concept are reviewed. De Vega annuloplasty has been used extensively throughout the world to correct tricuspid insufficiency, especially secondary functional regurgitation concomitantly with mitral valve surgery. It has also been used in traumatic injuries, heart transplantation or the child population. Compared with annuloplasty with a rigid or semirigid ring, it seems to confer less stability over time, without this having translated into an increase in morbidity and mortality or in the rate of reinterventions. It is a fast, simple, reproducible, economical, safe technique that offers excellent clinical results in selected patients, and that after 50 years is still valid, especially as a treatment for non-severe functional tricuspid regurgitation in the context of left valve surgery without significant dilatation of the right ventricle.
- Published
- 2023
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4. REPAIR - transcatheteR rEPair of mitrAl Insufficiency With caRdioband System (REPAIR)
- Published
- 2020
5. Cardiac Computed Tomography Screening for Tricuspid Transcatheter Annuloplasty Implantation.
- Author
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Barbieri, Fabian, Niehues, Stefan Markus, Feuchtner, Gudrun Maria, Skurk, Carsten, Landmesser, Ulf, Polak-Krasna, Katarzyna, Dreger, Henryk, Kasner, Mario, and Reinthaler, Markus
- Published
- 2024
- Full Text
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6. Resultados de la reparación mitral en endocarditis
- Author
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Carlos Domínguez-Massa, Ana M. Bel-Mínguez, Manuel Pérez-Guillen, Audelio Guevara-Bonilla, Paulina Briz-Echeverría, José A. Rincón-Almanza, Miguel Á. Arnau-Vives, Marino Blanes-Julia, Francisco J. Valera-Martínez, Fernando Hornero-Sos, and José A. Montero-Argudo
- Subjects
Endocarditis ,Mitral valve repair ,Cardiac valve annuloplasty ,Medicine ,Surgery ,RD1-811 - Abstract
Resumen: Introducción y objetivos: Se pretende demostrar la seguridad de la reparación valvular mitral en endocarditis. Material y método: Del 2008 al 2019, hubo un total de 22 casos de reparación mitral de etiología endocardítica en nuestro centro (14 de ellas corresponden a los tres últimos años). Edad media de 60,8 años, la mayoría varones (72,7%), con un EuroSCORE-II medio del 5,9 ± 7,9%. El 63,6% se trataban de endocarditis activas en el momento de la intervención. Resultados: En la mayoría de los casos existía prolapso del velo posterior (54,5%) o de ambos velos (13,6%). La técnica de reparación más usada fue la resección (36,4%), seguida del implante de neocuerdas (22,7%) y la combinación de neocuerdas con cierre de cleft (18,2%). Se empleó anillo en la mayoría de los casos (81,8%). Sólo un caso mantuvo hemocultivos positivos postoperatorios (infección por Candida parapsilosis). Con un seguimiento de 22,1 ± 20,0 meses, no hubo ningún éxitus y sólo un caso de necesidad de reintervención. Conclusiones: En la literatura, la reparación valvular mitral ha demostrado su superioridad en mortalidad, preservación de la función ventricular izquierda y disminución de eventos tromboembólicos respecto a la sustitución valvular mitral. No obstante, la tasa de reparación mitral en endocarditis es menor que la de enfermedad degenerativa. A la vista de nuestros resultados, con ausencia de mortalidad y baja tasa de fallos de reparación, asociado al aumento del número de casos y complejidad cada año, es una estrategia de elección siempre que sea técnicamente posible. Abstract: Introduction and objectives: The aim is to demonstrate the safety of mitral valve repair in endocarditis Material and method: From 2008 to 2019, there were a total of 22 cases of mitral repair of endocardial etiology in our center (14 of them correspond to the last 3 years). Average age of 60.8 years, most of them males (72.7%), with a mean EuroSCORE-II of 5.9 ± 7.9%. 63.6% were active endocarditis at the time of the intervention. Results: In most cases there was prolapse of the posterior leaflet (54.5%) or both leaflet (13.6%). The most used repair technique was resection (36.4%), followed by neo-chord implantation (22.7%) and the combination of neo-chords with cleft closure (18.2%). Ring was used in most cases (81.8%). Only 1 case maintained positive postoperative blood cultures (Candida parapsilosis infection). With a follow-up of 22.1 ± 20.0 months, there were no deaths and only 1 case of need for reoperation. Conclusions: In the literature, mitral valve repair has shown superiority in mortality, preservation of left ventricular function, and decrease in thromboembolic events compared to mitral valve replacement. However, the mitral repair rate in endocarditis is lower than degenerative disease. In view of our results, with absence of mortality and low rate of repair failure, associated with the increase in the number of cases and complexity each year, it is a strategy of choice whenever technically possible.
- Published
- 2020
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7. Mid-term outcomes of tricuspid annuloplasty using the Tri-Ad Adams tricuspid annuloplasty ring.
- Author
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Lee H, Kim J, Jung JH, and Yoo JS
- Abstract
Objectives: The Tri-Ad Adams tricuspid annuloplasty ring is a recent innovative prosthesis characterized by a semi-rigid central component and fully flexible extremities. The goal of this study was to assess the short-term and mid-term results following implantation of the Tri-Ad Adams ring., Methods: A retrospective analysis was conducted on patients who underwent tricuspid annuloplasty using the Tri-Ad Adams ring between August 2016 and October 2021., Results: Our study enrolled a total of 248 participants. The median age was 64.0 (interquartile range: 56.0-71.5) years. The median EuroSCORE II was 4.3% (2.7-7.5%), with 37 patients (14.9%) having a history of cardiac operations. Tricuspid regurgitation of grade 2-3 was observed in 63.7% of cases, and the median tricuspid annular diameter was 3.3 (2.8-3.6) cm. Concurrent procedures included mitral valve replacement (n = 160, 64.5%), mitral valve repair (n = 75, 30.2%), aortic valve replacement (n = 72, 29.0%) and the maze procedure (n = 170, 68.5%). Immediate postoperative tricuspid regurgitation≥moderate was present in 1 patient (0.4%). Early death occurred in 14 patients (5.6%). Major complications included low cardiac output syndrome (n = 18, 0.3%), acute kidney injury (n = 14, 5.6%) and permanent pacemaker placement (n = 15, 6.0%). According to the Kaplan-Meier analysis, the 4-year rates of freedom from overall mortality and moderate-to-severe tricuspid regurgitation were 96.9% and 91.6%, respectively. There were no incidents of tricuspid valve reoperations, ring detachment or significant tricuspid stenosis (trans-tricuspid valve gradient ≥ 5 mmHg)., Conclusions: Tricuspid annuloplasty utilizing the Tri-Ad Adams ring demonstrated favourable outcomes in both the early and midterm periods. Further studies are warranted to confirm the long-term results., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
- Published
- 2024
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8. Right Coronary Artery Injury in Transcatheter Annuloplasty for Secondary Tricuspid Regurgitation: A Real-World Multicenter Study.
- Author
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Althoff J, Gietzen T, Hasse C, Rudolph V, Gerçek M, Friedrichs KP, Kalbacher D, Koell B, Pfister R, and Koerber MI
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- Aged, Aged, 80 and over, Female, Humans, Male, Coronary Vessels diagnostic imaging, Coronary Vessels injuries, Coronary Vessels surgery, Heart Injuries etiology, Heart Injuries diagnostic imaging, Heart Injuries therapy, Heart Injuries surgery, Heart Valve Prosthesis, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Vascular System Injuries diagnostic imaging, Vascular System Injuries etiology, Vascular System Injuries surgery, Cardiac Catheterization instrumentation, Cardiac Catheterization adverse effects, Cardiac Valve Annuloplasty, Heart Valve Prosthesis Implantation instrumentation, Heart Valve Prosthesis Implantation adverse effects, Tricuspid Valve surgery, Tricuspid Valve diagnostic imaging, Tricuspid Valve physiopathology, Tricuspid Valve Insufficiency surgery, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency physiopathology, Tricuspid Valve Insufficiency etiology
- Published
- 2024
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9. Surgical management of systemic right ventricular failure.
- Author
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Masaki S, Itatani K, Shibata T, and Suda H
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- Humans, Middle Aged, Treatment Outcome, Tricuspid Valve surgery, Tricuspid Valve diagnostic imaging, Tricuspid Valve physiopathology, Recovery of Function, Male, Severity of Illness Index, Heart Valve Prosthesis Implantation, Cardiac Valve Annuloplasty, Cardiac Surgical Procedures, Tricuspid Valve Insufficiency surgery, Tricuspid Valve Insufficiency physiopathology, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency etiology, Heart Failure physiopathology, Heart Failure etiology, Heart Failure surgery, Heart Failure diagnostic imaging, Ventricular Dysfunction, Right physiopathology, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Dysfunction, Right surgery, Ventricular Function, Right, Cardiac Resynchronization Therapy
- Abstract
Severe systemic right ventricular failure with tricuspid regurgitation is associated with poor prognosis. Here, we report a case of 49-year-old patient who experienced severe systemic right ventricular failure following atrial switch. We chose the surgical strategy for this challenging case using comprehensive four-dimensional imaging. The patient underwent tricuspid valve repair and cardiac resynchronization therapy and recovered with improved cardiac function and regulated tricuspid valve regurgitation., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The corresponding author K.I. has a following conflicts of interest associated with this manuscript: A Stock Option from Cardio Flow Design Inc., which delivers blood flow imaging tools.
- Published
- 2024
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10. Analysis of tricuspid annulus dimensions and RCA-proximity with artificial intelligence-based software for procedural planning of percutaneous tricuspid annuloplasty.
- Author
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Kirchner J, Gesch J, Gercek M, Piran M, Friedrichs K, Pfister R, Rudolph F, Potratz M, Goncharov A, Ivannikova M, Rudolph V, and Rudolph TK
- Subjects
- Humans, Male, Treatment Outcome, Radiographic Image Interpretation, Computer-Assisted, Software, Female, Coronary Angiography, Computed Tomography Angiography, Aged, Cardiac Catheterization instrumentation, Heart Valve Prosthesis Implantation instrumentation, Heart Valve Prosthesis Implantation adverse effects, Middle Aged, Clinical Decision-Making, Tricuspid Valve diagnostic imaging, Tricuspid Valve surgery, Tricuspid Valve physiopathology, Predictive Value of Tests, Cardiac Valve Annuloplasty, Artificial Intelligence, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency surgery, Tricuspid Valve Insufficiency physiopathology
- Abstract
Competing Interests: Declaration of competing interest Kai Friedrichs is consultant for and has received speaker's honoraria from Edwards Lifesciences. Maria Ivannikova has received speaker's honoraria from Edwards Lifesciences and AstraZeneca. Tanja K. Rudolph has received speaker's honoraria from Edwards Lifesciences. Volker Rudolph has received grants from Edwards Lifesciences and Abbott. Johannes Kirchner, Johannes Gesch, Muhammed Gercek; Misagh Piran, Roman Pfister, Felix Rudolph, Max Potratz, Arsenyi Goncharov declare to have no conflicts of interest.
- Published
- 2024
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11. Anticoagulation for Cardiac Prosthetic Devices: Prosthetic Heart Valves, Left Ventricular Assist Devices, and Septal Closure Devices
- Author
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Crim, Matthew T., Shore, Supriya, Lee, Suegene K., Wells, Bryan J., Lau, Joe F., editor, Barnes, Geoffrey D., editor, and Streiff, Michael B., editor
- Published
- 2018
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12. Comparison of different pulmonary valve reconstruction techniques during transannular repair of tetralogy of fallot.
- Author
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Temur, Bahar, Aydın, Selim, Suzan, Dilek, Kırat, Barış, Demir, Ibrahim Halil, and Erek, Ersin
- Subjects
- *
PULMONARY valve , *TETRALOGY of Fallot , *RESPIRATORY insufficiency , *PULMONARY stenosis , *INTENSIVE care units - Abstract
Background: Transannular patch, which results in pulmonary insufficiency (PI), is usually required during repair of tetralogy of fallot (TOF). In this study, we compared three types of pulmonary valve reconstruction techniques during transannular repair of TOF. Methods: Between February 2014 and January 2018, 50 patients with TOF underwent primary repair with transannular patch. These patients were divided into three groups. In Group 1, (n = 15), a single gluteraldehyde‐treated autologous pericardial patch (standard method) was reconstructed as monocusp. In Group 2, (n = 16) Nunn's bileaflet pulmonary valve reconstruction technique was used with pericardial patch. In Group 3, (n = 19), Nunn's bileaflet technique was performed with expanded polytetrafluoroethylene membrane. The outcomes of the patients and early and midterm competency of the pulmonary valves were analyzed. Results: These techniques were significantly effective in early postoperative period. Freedom from moderate to severe PI were 73.3%; 100% and 89.4%, respectively. Mortality, duration of intensive care unit and hospital stay were similar between the groups. The mean follow‐up period was 17.5 ± 13.0 (3–57) months. Freedom from moderate to severe PI decreased to 40%; 81.2% and 73.7%, respectively at the end of the follow‐up period. Presence of moderate to severe PI was significantly higher in Group 1 (p =.018 between Groups 1 and 2, p =.048 between Groups 1 and 3). Conclusion: All three pulmonary valve reconstruction techniques provided competent pulmonary valves. Nunn's bileaflet technique had better outcome at midterm. It has a potential to delay right ventricular dysfunction at long‐term. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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13. Tricuspid repair: short and long-term results of suture annuloplasty techniques and rigid and flexible ring annuloplasty techniques.
- Author
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Türkmen U, Bozkurt T, Özyalçın S, Günaydın I, and Kaplan S
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- Adult, Humans, Treatment Outcome, Tricuspid Valve surgery, Mitral Valve surgery, Suture Techniques, Tricuspid Valve Insufficiency surgery, Tricuspid Valve Insufficiency diagnosis, Heart Valve Prosthesis Implantation methods, Cardiac Valve Annuloplasty
- Abstract
Background: Functional tricuspid regurgitation may arise from left heart valve diseases or other factors. If not addressed concurrently with primary surgical intervention, it may contribute to increased morbidity and mortality rates during the postoperative period. This study investigates the impact of various repair techniques on crucial factors such as systolic pulmonary artery pressure (SPAP), tricuspid valve regurgitation, and New York Heart Association (NYHA) functional capacity class in the postoperative period., Materials and Methods: From April 2007 to June 2013, 379 adults underwent open-heart surgery for functional tricuspid regurgitation. Patients were categorized into four groups: Group 1 (156) with De Vega suture annuloplasty, Group 2 (60) with Kay suture annuloplasty, Group 3 (122) with Flexible Duran ring annuloplasty, and Group 4 (41) with Semi-Rigid Carpentier-Edwards ring annuloplasty. Demographic, clinical, operative, and postoperative data were recorded over a mean follow-up of 35.6 ± 19.1 months. Postoperative SPAP values, tricuspid regurgitation grades, and NYHA functional capacity classes were compared among the groups., Results: No statistically significant differences were observed among the groups regarding age, gender, preoperative disease diagnoses, history of previous cardiac operations, or echocardiographic characteristics such as preoperative ejection fraction, SPAP, and tricuspid regurgitation. Hospital and intensive care unit length of stay and postoperative complications also showed no significant differences. However, patients in Group 3 exhibited longer Cardio-Pulmonary Bypass duration, cross-clamp duration, and higher positive inotrope requirements. While the mortality rate within the first 30 days was higher in Group 1 compared to the other groups (p: 0.011), overall mortality rates did not significantly differ among the groups. Significant regression in functional tricuspid regurgitation and a notable decrease in SPAP values were observed in patients from Group 3 and Group 4 (p: 0.001). Additionally, patients in Group 3 and Group 4 showed a more significant reduction in NYHA functional capacity classification during the postoperative period (p: 0.001)., Conclusion: Among the repair techniques, ring annuloplasty demonstrated superiority in reducing SPAP, regressing tricuspid regurgitation, and improving NYHA functional capacity in functional tricuspid regurgitation repairs., (© 2024. The Author(s).)
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- 2024
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14. Early Clinical Outcomes of Tricuspid Valve Repair with a Tri-Ad Annuloplasty Ring in Comparison with the Outcomes Using an MC³ Ring
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Woohyun Jung, Jae Woong Choi, Ho Young Hwang, and Kyung Hwan Kim
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Tricuspid valve ,Tricuspid valve insufficiency ,Cardiac valve annuloplasty ,Surgery ,RD1-811 - Abstract
Background: We evaluated the early clinical outcomes of tricuspid valve annuloplasty (TAP) with the Tri-Ad annuloplasty ring for functional tricuspid regurgitation (TR). Methods: From January 2015 to March 2017, 36 patients underwent TAP with a Tri-Ad ring for functional TR. To evaluate the early clinical outcomes of TAP with the Tri-Ad ring, we conducted a propensity score-matched analysis comparing the Tri-Ad and MC³ tri-cuspid annuloplasty rings (n=34 in each group). The follow-up duration was 11.0±7.07 months. Results: There was 1 case of operative mortality (2.8%) and no cases of late mortality. Postoperative complications occurred in 15 patients (41%), including acute kidney injury in 6 patients (16%), bleeding requiring reoperation in 4 patients (11%), and low cardiac output syndrome in 4 patients (11%). There were no ring-related complications, such as atrioventricular block or ring dehiscence. The TR grade decreased significantly (from 2.03±1.06 to 1.18±0.92, p
- Published
- 2018
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15. Minimally invasive dual-valve repair in situs inversus totalis: strategy for tricuspid valve.
- Author
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Kishimoto, Noriaki, Shibata, Toshihiko, Yamane, Kokoro, Fujii, Hiromichi, Takahashi, Yosuke, and Murakami, Takashi
- Abstract
A 70-year-old man, diagnosed with severe mitral regurgitation and moderate tricuspid regurgitation with situs inversus totalis, was referred to our hospital. A minimally invasive approach via a minithoracotomy was performed. The mitral valve was repaired with the loop technique and ring annuloplasty. With an asymmetric shape of the tricuspid valve, the use of a conventional rigid ring was not feasible. Therefore, flexible ring annuloplasty had to be performed. The minimally invasive approach for mirror-image anatomy did not pose an unusual technical challenge. It was safely performed in the context of situs inversus totalis. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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16. Early outcomes of mitral valvuloplasty by minimally invasive surgery or sternotomy.
- Author
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Huang, Huan-lei, Yan, Qian, Xie, Xu-jing, Zhou, Kan, He, Biao-chuan, and Yang, Liang
- Abstract
Background: Disagreement exists regarding methods for repair of the mitral valve. We compared early outcomes of mitral valvuloplasty by a minimally invasive technique and by a median sternotomy. Methods: The data of 507 patients (mean age 47.9 ± 15.2 years) undergoing mitral valvuloplasty from January 2015 to June 2018 were analyzed retrospectively. In the study group (n = 225), mitral valvuloplasty via a totally thoracoscopic approach was performed by a single surgeon. In the control group (n = 282), mitral valvuloplasty via the traditional median sternotomy was carried out by other cardiac surgeons in our hospital. Clinical data, surgical results, and follow-up findings in the two groups were comparatively analyzed. Results: In the study group, the blood transfusion rate (5.3% vs. 20.9%, p < 0.05) and incidences of poor wound healing (0 vs. 5.3%, p < 0.05) and respiratory tract infection (4.4% vs. 16.3%, p < 0.05) were lower, and postoperative hospitalization was shorter (5.9 ± 4.0 vs. 10.7 ± 8.4 days, p < 0.05). Within 30 days after surgery, no patient died in the study group while one died in the control group. The duration of follow-up was 12–36 months (mean 22.9 ± 8.8 months). During follow-up, there were 1 and 0 cases of redo surgery and 1 and 3 deaths in the study group and control group, respectively. Conclusion: Mitral valvuloplasty via a minimally invasive approach is superior to the traditional median sternotomy in terms of early outcomes, especially when performed by experienced surgeons. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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17. A Woman with Systemic Lupus Erythematosus and Odd Valvular Presentation: A Case Report.
- Author
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Bazyar, Zohre, Moaref, Alireza, Amirghofran, Ahmad Ali, Nazarinia, Mohammadali, and Kojuri, Javad
- Subjects
- *
INFECTIVE endocarditis , *TRANSESOPHAGEAL echocardiography , *AORTIC stenosis , *PHOSPHOLIPID antibodies , *ANTIPHOSPHOLIPID syndrome , *MEDICAL logic , *SYSTEMIC lupus erythematosus - Abstract
Objective: Unusual clinical course Background: Systemic lupus erythematosus (SLE) is a systemic disease with various cardiac and non-cardiac presentations. We present the case of a young woman with odd presentation of SLE mistakenly identified as a valve abscess that was scheduled for surgery. Case Report: This 35-year-old woman presented with rapid progression of aortic stenosis, and the transesophageal echocardiography report showed a misdiagnosed aortic web (congenital) and aortic wall abscess. She was scheduled for surgery as a case of subacute bacterial endocarditis (SBE) and aortic abscess, despite lack of fever. Conclusions: Cardiovascular involvement should be considered in any SLE patient, especially those with high SLE scores, even with negative antiphospholipid antibody. Cardiovascular involvement may be odd and misleading in some cases, which may warrant especial attention and experienced caregivers for clinical reasoning and proper management. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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18. Anuloplastia tricuspídea percutánea con dispositivo Cardioband®.
- Author
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Martínez Pérez, José, Valverde Bernal, Jonatan, and Castelló Fosch, Núria
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TRICUSPID valve surgery ,HEART valve diseases ,HEART valve surgery - Abstract
The article offers information on percutaneous tricuspid annuloplasty with Cardioband device and a patient diagnosed with functional Tricuspid regurgitation (TR) grade V. Topics include the guides clinical practice of the European Association for CardioThoracic Surgery and others on the treatment of choice in symptomatic patients; an imaging study with echocardiogram; and the hemodynamics laboratory guided by transesophageal echocardiography (TEE).
- Published
- 2021
19. Midterm Comparison Between Different Annuloplasty Techniques for Functional Tricuspid Regurgitation
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Tine Philipsen, Yves Van Belleghem, Isabelle Claus, Thierry Bové, Katrien François, Jens Czapla, and Thomas Martens
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Hypertension, Pulmonary ,Ventricular Dysfunction, Right ,Cardiac Valve Annuloplasty ,Functional tricuspid regurgitation ,Internal medicine ,Diabetes mellitus ,medicine ,Clinical endpoint ,Humans ,Retrospective Studies ,Tricuspid valve ,business.industry ,Combined procedure ,medicine.disease ,Pulmonary hypertension ,Tricuspid Valve Insufficiency ,Treatment Outcome ,medicine.anatomical_structure ,Aortic Valve ,Concomitant ,Circulatory system ,Cardiology ,Mitral Valve ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
Several tricuspid annuloplasty (TA) techniques are used for concomitant repair of functional tricuspid regurgitation (TR). This study compared the midterm clinical and valvular outcome among 3 annuloplasty techniques.TA was performed in 307 patients (aged 75.9 ± 10.4 years) with a rigid ring (RA) in 184, a flexible band (FA) in 80, or a suture annuloplasty (SA) in 43. Study end points were survival and recurrence of TRgrade 2 at 5 years.TA was performed concomitantly to mitral valve surgery in 136 patients (44.3%), aortic valve surgery in 18 (5.9%), coronary artery bypass grafting in 13 (4.2%), or a combined procedure in 140 (45.6%). Most had TRgrade 2 (78.5%), without significant differences between the TA groups (P = .878). Within a median follow-up of 3.4 years (interquartile range, 2.2-5.0 years), the 5-year survival was 80.1% ± 3.4% for RA, 83.5% ± 4.7% for FA, and 85.1% ± 6.5% for SA (P = .471). Independent risk factors for late mortality were renal impairment (hazard ratio [HR], 2.83; 95% CI, 1.16-6.89; P = .022), diabetes (HR, 2.10; 95% CI, 1.07-4.11; P = .030), and severe right ventricular dysfunction by tricuspid annulus plane systolic excursion10 mm (HR, 11.52; 95% CI, 4.98-26.66; P.001). Pulmonary hypertension was nearly significant (HR, 1.92; 95% CI, 0.98-3.74; P = .057). The cumulative incidence of TR recurrence at 5 years was 15.9%, 19.4%, and 21.1% for RA, FA, and SA, respectively (P = .342). Severe pulmonary hypertension (HR, 2.64; 95% CI, 1.38-5.07; P = .003), preoperative TR grade (HR, 1.82; 95% CI, 1.01-3.27; P = .046), and residual TRgrade 2 at discharge (HR, 3.38; 95% CI, 1.64-6.96; P = .001) were predictive for later TR recurrence, regardless of the annuloplasty technique.This study demonstrates that advanced pathophysiological right circulatory impairment, such as severe pulmonary hypertension and right ventricular dysfunction, affects the midterm survival and TR recurrence rate more than the annuloplasty technique used for concomitant repair of functional TR.
- Published
- 2022
20. Valve-Sparing Root Replacement: Aortic Root Remodeling with External Subvalvular Ring Annuloplasty
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Sang-Ho Cho, Dae Hyun Kim, and Young Tae Kwak
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Aortic root ,Aortic aneurysm ,Aortic valve ,surgery ,Cardiac valve annuloplasty ,Surgery ,RD1-811 - Abstract
The original valve-sparing procedures for aortic root aneurysms were remodeling and reimplantation of the aortic root. The remodeling technique provides more physiologic movement of the cusps within 3 reconstructed neo-sinuses, thus preserving root expansibility through the interleaflet triangles. However, the durability of remodeling has been a matter of concern due to the high rate of aortic insufficiency when annular dilation is not addressed. Therefore, a modified approach was developed, combining a physiologic remodeling of the root with a subvalvular annuloplasty. This case report highlights the first case of successful aortic root remodeling with external subvalvular ring annuloplasty in Korea.
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- 2016
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21. The K-clip™: Time for a new tricuspid valve focal annuloplasty system.
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Sisinni A and Estevez-Loureiro R
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- Humans, Tricuspid Valve diagnostic imaging, Tricuspid Valve surgery, Mitral Valve surgery, Aortic Valve surgery, Treatment Outcome, Tricuspid Valve Insufficiency surgery, Cardiac Valve Annuloplasty, Heart Valve Prosthesis Implantation
- Abstract
Competing Interests: Declaration of Competing Interest Dr. Estevez-Loureiro has received honoraria from Abbott Vascular, Edwards Lifesciences, Boston Scientific and Venus Medtech. The rest of authors have nothing to disclose.
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- 2023
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22. New trend: Surgical correction of Ebstein's anomaly using modified cone repair and a combination of different techniques
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Nihat Çine and Kenan A. Kara
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Adult ,Male ,Pulmonary and Respiratory Medicine ,Adolescent ,Heart Ventricles ,Infant ,Middle Aged ,Cardiac Valve Annuloplasty ,Tricuspid Valve Insufficiency ,Ebstein Anomaly ,Young Adult ,Child, Preschool ,Humans ,Female ,Surgery ,Tricuspid Valve ,Child ,Cardiology and Cardiovascular Medicine - Abstract
Ebstein's anomaly,a rare cardiac disease that accounts for1% of all congenital heart diseases, is a right ventricular myopathy with varying degrees of delamination in the endocardium under the tricuspid valve. Cone reconstruction, first described by da Silva in 2004, is a modification of the Carpentier technique. An alternative surgical treatment for Ebstein's anomaly, it is now the preferred surgical corrective technique.This study demonstrates that our modifications of the cone repair procedure to correct Ebstein's anomaly improve valve coaptation and stabilization in the early and midterm.Of the 134 patients diagnosed with Ebstein's anomaly in our clinic between January 2012 and October 2020, 10 underwent a cone procedure and its modifications and were thus included in the study. The mean age of these patients was 28.6 ± 18.79 years and ranged from 1 to 61 years. Thirty percent of the patients were male and 70% were female.The additional procedures performed were an isolated cone procedure (two patients), anomalous pulmonary venous return repair in addition to a cone procedure (one patient), single-vessel coronary artery bypass (one patient), Glenn procedure (two patients), and tricuspid ring annuloplasty (four patients).Based on the results of this study, which assesses the outcomes of patients who underwent cone repairs with surgical modifications, we argue that right ventricular oblique plication, tricuspid valve delamination, surgical valve rotation, and tricuspid ring annuloplasty protect valve coaptation and function in the early and midterm, thereby having beneficial effects on right ventricle remodeling.
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- 2022
23. Long-term outcomes of atrioventricular septal defect and single ventricle: A multicenter study
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Tjark Ebels, Pieter C van de Woestijne, Judith M. Vonk, Thierry Bové, Geoffroy de Beco, Bart Meyns, Joeri Van Puyvelde, Rinske IJsselhof, Douwe Postmus, Ad J.J.C. Bogers, Sara C. Arrigoni, Mark G. Hazekamp, Paul H. Schoof, Friso M. Rijnberg, Alain Poncelet, Katrien François, Life Course Epidemiology (LCE), Value, Affordability and Sustainability (VALUE), Groningen Research Institute for Asthma and COPD (GRIAC), Cardiovascular Centre (CVC), Cardiothoracic Surgery, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, and UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique
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Male ,Time Factors ,Databases, Factual ,030204 cardiovascular system & hematology ,Fontan Procedure ,Univentricular Heart ,0302 clinical medicine ,Belgium ,Risk Factors ,Medicine and Health Sciences ,Cumulative incidence ,Hospital Mortality ,Atrioventricular Septal Defect ,Netherlands ,Incidence ,Mortality rate ,Incidence (epidemiology) ,PALLIATION ,Treatment Outcome ,medicine.anatomical_structure ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Fontan ,Reoperation ,Pulmonary and Respiratory Medicine ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,FONTAN OPERATION ,Regurgitation (circulation) ,Risk Assessment ,Cardiac Valve Annuloplasty ,03 medical and health sciences ,single ventricle ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Cardiac Surgical Procedures ,Retrospective Studies ,VALVE FAILURE ,REPAIR ,Atrioventricular valve ,business.industry ,Heart Septal Defects ,030228 respiratory system ,Ventricle ,Concomitant ,Surgery ,business - Abstract
OBJECTIVE: The study objective was to analyze survival and incidence of Fontan completion of patients with single-ventricle and concomitant unbalanced atrioventricular septal defect. METHODS: Data from 4 Dutch and 3 Belgian institutional databases were retrospectively collected. A total of 151 patients with single-ventricle atrioventricular septal defect were selected; 36 patients underwent an atrioventricular valve procedure (valve surgery group). End points were survival, incidence of Fontan completion, and freedom from atrioventricular valve reoperation. RESULTS: Median follow-up was 13.4 years. Cumulative survival was 71.2%, 70%, and 68.5% at 10, 15, and 20 years, respectively. An atrioventricular valve procedure was not a risk factor for mortality. Patients with moderate-severe or severe atrioventricular valve regurgitation at echocardiographic follow-up had a significantly worse 15-year survival (58.3%) compared with patients with no or mild regurgitation (89.2%) and patients with moderate regurgitation (88.6%) (P = .033). Cumulative incidence of Fontan completion was 56.5%, 71%, and 77.6% at 5, 10, and 15 years, respectively. An atrioventricular valve procedure was not associated with the incidence of Fontan completion. In the valve surgery group, freedom from atrioventricular valve reoperation was 85.7% at 1 year and 52.6% at 5 years. CONCLUSIONS: The long-term survival and incidence of Fontan completion in our study were better than previously described for patients with single-ventricle atrioventricular septal defect. A concomitant atrioventricular valve procedure did not increase the mortality rate or decrease the incidence of Fontan completion, whereas patients with moderate-severe or severe valve regurgitation at follow-up had a worse survival. Therefore, in patients with single-ventricle atrioventricular septal defect when atrioventricular valve regurgitation exceeds a moderate degree, the atrioventricular valve should be repaired. ispartof: JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY vol:163 issue:3 pages:1166-1175 ispartof: location:United States status: published
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- 2022
24. Concomitant Tricuspid Repair in Patients with Degenerative Mitral Regurgitation
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Michael A. Borger, Alan J Moskowitz, Friedhelm Beyersdorf, Steven F. Bolling, Lenard Conradi, Michael E Bowdish, Judy Hung, Pierre Voisine, Jessica Overbey, Eric A. Rose, John C. Mullen, Samantha Raymond, Annetine C. Gelijns, Neal Jeffries, Mariell Jessup, Karen O'Sullivan, Marissa A. Miller, James S. Gammie, Alexander Iribarne, Mary E. Marks, Arnar Geirsson, Michael J Mack, Ctsn Investigators, Babatunde Yerokun, Ellen Moquete, Emilia Bagiella, Richard D. Weisel, Marc Gillinov, Volkmar Falk, Markus Krane, Gorav Ailawadi, Patrick T. O'Gara, Michael W A Chu, Michael K. Parides, and Wendy C. Taddei-Peters
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Male ,Reoperation ,medicine.medical_specialty ,Pacemaker, Artificial ,macromolecular substances ,Cardiac Valve Annuloplasty ,Postoperative Complications ,Internal medicine ,medicine ,Humans ,In patient ,cardiovascular diseases ,Aged ,Mitral regurgitation ,business.industry ,Mitral Valve Insufficiency ,General Medicine ,Survival Analysis ,Tricuspid Valve Insufficiency ,Intention to Treat Analysis ,Concomitant ,Regurgitation (digestion) ,cardiovascular system ,Cardiology ,Disease Progression ,Quality of Life ,Mitral Valve ,Female ,Tricuspid Valve ,medicine.symptom ,business ,Dilatation, Pathologic ,Follow-Up Studies - Abstract
Tricuspid regurgitation is common in patients with severe degenerative mitral regurgitation. However, the evidence base is insufficient to inform a decision about whether to perform tricuspid-valve repair during mitral-valve surgery in patients who have moderate tricuspid regurgitation or less-than-moderate regurgitation with annular dilatation.We randomly assigned 401 patients who were undergoing mitral-valve surgery for degenerative mitral regurgitation to receive a procedure with or without tricuspid annuloplasty (TA). The primary 2-year end point was a composite of reoperation for tricuspid regurgitation, progression of tricuspid regurgitation by two grades from baseline or the presence of severe tricuspid regurgitation, or death.Patients who underwent mitral-valve surgery plus TA had fewer primary-end-point events than those who underwent mitral-valve surgery alone (3.9% vs. 10.2%) (relative risk, 0.37; 95% confidence interval [CI], 0.16 to 0.86; P = 0.02). Two-year mortality was 3.2% in the surgery-plus-TA group and 4.5% in the surgery-alone group (relative risk, 0.69; 95% CI, 0.25 to 1.88). The 2-year prevalence of progression of tricuspid regurgitation was lower in the surgery-plus-TA group than in the surgery-alone group (0.6% vs. 6.1%; relative risk, 0.09; 95% CI, 0.01 to 0.69). The frequencies of major adverse cardiac and cerebrovascular events, functional status, and quality of life were similar in the two groups at 2 years, although the incidence of permanent pacemaker implantation was higher in the surgery-plus-TA group than in the surgery-alone group (14.1% vs. 2.5%; rate ratio, 5.75; 95% CI, 2.27 to 14.60).Among patients undergoing mitral-valve surgery, those who also received TA had a lower incidence of a primary-end-point event than those who underwent mitral-valve surgery alone at 2 years, a reduction that was driven by less frequent progression to severe tricuspid regurgitation. Tricuspid repair resulted in more frequent permanent pacemaker implantation. Whether reduced progression of tricuspid regurgitation results in long-term clinical benefit can be determined only with longer follow-up. (Funded by the National Heart, Lung, and Blood Institute and the German Center for Cardiovascular Research; ClinicalTrials.gov number, NCT02675244.).
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- 2023
25. Rigid Ring Versus Flexible Band for Tricuspid Valve Repair in Patients Scheduled for Mitral Valve Surgery: A Prospective Randomised Study
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Andrey V. Sapegin, Sergey O. Lavinykov, Michail A. Ovcharov, Alexander V. Afanasyev, Alexander Bogachev-Prokophiev, Sergey I Zeleznev, Dmitriy A Astapov, Sergey M Ivanzov, Ravil Sharifulin, and Igor Demin
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Mitral Valve Annuloplasty ,Regurgitation (circulation) ,Cardiac Valve Annuloplasty ,Internal medicine ,Humans ,Medicine ,In patient ,Prospective Studies ,cardiovascular diseases ,TRICUSPID VALVE REPAIR ,Heart Valve Prosthesis Implantation ,Ring (mathematics) ,Tricuspid valve ,business.industry ,Mitral Valve Insufficiency ,Tricuspid Valve Insufficiency ,Treatment Outcome ,medicine.anatomical_structure ,Ventricle ,Concomitant ,cardiovascular system ,Cardiology ,Mitral Valve ,Tricuspid Valve ,Neoplasm Recurrence, Local ,Cardiology and Cardiovascular Medicine ,business ,Mitral valve surgery - Abstract
Background Tricuspid valve repair for functional regurgitation is effectively performed with different annuloplasty devices. However, it remains unclear whether there are advantages associated with rigid rings compared to flexible bands. This prospective randomised study aimed to compare results of using a flexible band ring versus a rigid ring for functional tricuspid regurgitation in patients undergoing mitral valve surgery. Methods A single-centre randomised study was designed to allocate patients with functional tricuspid regurgitation undergoing mitral valve surgery to be treated with a flexible band or rigid ring. These patients were analysed by echocardiographic follow-up. The primary outcome was freedom from recurrent tricuspid regurgitation at 12-months follow-up. Secondary outcomes were 30-day mortality, survival, freedom from tricuspid valve reoperation, right ventricular reverse remodelling, and rate of major adverse events. Results A total of 308 patients were allocated to receive concomitant tricuspid valve annuloplasty with the flexible band or rigid ring. There was no between-group difference in freedom from recurrent tricuspid regurgitation: 97.3% in Rigid group (95% CI, 93.0-98.8) and 96.2% in the Flexible group (95% CI, 92.0-98.5) at 12-months follow-up (log-rank, p=0.261). Early mortality, survival, freedom from tricuspid valve reoperation, and global right ventricle systolic function were also comparable in both groups of patients. However, the flexible band had advantage in restoring regional right ventricle function (Doppler-derived systolic velocities of the annulus [S], tricuspid annular plane systolic excursion) at 12-months follow-up. Conclusion Both the rigid ring and flexible band offered acceptable outcomes for functional tricuspid regurgitation correction without significant differences, as assessed at 12-months follow-up.
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- 2021
26. Bicuspid aortic valve repair with external or subcommissural annuloplasty—echocardiographic prospective trial
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Piotr Pysz, Marek A. Deja, Andrzej Kansy, Izabella Wenzel-Jasinska, Radosław Gocoł, Tomasz Plonek, Marek Jasinski, and Damian Hudziak
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Aortic Valve Insufficiency ,Hemodynamics ,Cardiac Valve Annuloplasty ,Bicuspid aortic valve ,Aortic valve repair ,Bicuspid Aortic Valve Disease ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Cardiac skeleton ,Single institution ,Retrospective Studies ,Aortic dilatation ,business.industry ,Middle Aged ,medicine.disease ,Treatment Outcome ,Echocardiography ,Prospective trial ,Aortic Valve ,Cardiology ,Female ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
The incompetent bicuspid aortic valve (BAV) can be repaired using various techniques. This study presents a prospective comparison of external and subcommissural aortic annuloplasty.Fifty consecutive patients (38 males, age: 43.9 ± 15.8 years) with BAV insufficiency with or without aortic dilatation underwent valve repair in a single institution. They were prospectively allocated to one of two groups based on the aortic annulus stabilization technique: 25 patients were operated on using the subcommissural annuloplasty (SCA) and 25 using the external complete annuloplasty (EA). Transthoracic echocardiography was performed in all patients before the operation and 1 and 3 years after the operation. Moreover, mortality and morbidity at 7 years were evaluated.In prospective echocardiographic comparison, EA was associated with smaller diameter of the aortic annulus (24.1 ± 2.6 mm vs. 25.8±2.1 mm, p .05) and lower mean and peak transvalvular gradients (7 ± 4 mmHg vs. 13 ± 4 mmHg, p = .02 and 15.3 ± 9.7 mmHg vs. 20.7 ± 5.6 mmHg, p = .03, respectively). No patients died or required reoperation due to recurrent insufficiency at 6,81 (interquartile range-0,17) years after the operation. The Kaplan-Meier actuarial freedom from aortic regurgitation (AR) grade =2 or gradient20 mmHg at 35.1 ± 3.6 months years was 96% (24 out of 25) for patients who had external annuloplasty and amounted to 76% (19 out of 25) for those who had SCA, p = .05).External annuloplasty performed during repair of the BAV is associated with better hemodynamics at medium-term follow-up compared to SCA.
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- 2021
27. Early results after aortic annuloplasty with a complete external Dacron band
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Jan Otto Beitnes, Runar Lundblad, and John-Peder Escobar Kvitting
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Reoperation ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Aortic Valve Insufficiency ,Regurgitation (circulation) ,Cardiac Valve Annuloplasty ,Bicuspid aortic valve ,Aortic valve repair ,Internal medicine ,Humans ,Medicine ,Endocarditis ,Polyethylene Terephthalates ,business.industry ,General Medicine ,medicine.disease ,Cardiac surgery ,Treatment Outcome ,Early results ,Cardiothoracic surgery ,Aortic Valve ,Cardiology ,Mitral Valve ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective This study evaluates the early results of our initial experience with aortic annuloplasty using a complete external Dacron band in the setting of type Ic or type II aortic regurgitation (AR). Methods From May 2017 to August 2019, 16 patients (88% bicuspid aortic valves, no patients with connective tissue disorders) underwent aortic annuloplasty with an external complete Dacron band. Clinical and echocardiographic follow-up was 100% complete. Clinical and echocardiographic follow-up averaged 24.4 ± 9.3 and 15.1 ± 8.3 months, respectively. Results Mean cardiopulmonary and cross-clamp times were 105 ± 15 (72–127) and 86 ± 15 (51–113) min, respectively. Early and late mortality was 0%, with no incidents of endocarditis or cerebrovascular events during the follow-up. Two patients were re-operated during the follow-up, one due recurrent aortic regurgitation (12 months after the first operation) yielding a freedom from reoperation due to AR at 1 year and 3 years of 100% ± 0% and 93.3% ± 5.7%, respectively. Based on the latest echocardiogram, five patients had either none or trivial AR, six had mild AR, and three had mild-to-moderate AR. Conclusions The early clinical and echocardiographic results after using a complete external Dacron band are promising; however, more data and longer follow-up are needed to determine its role in annular management during aortic valve repair.
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- 2021
28. Outcomes and Echocardiographic Follow-up After Surgical Management of Tricuspid Regurgitation in Patients With Transvenous Right Ventricular Leads
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Hartzell V. Schaff, Grace Lin, Ying Huang, Alberto Pochettino, Brian D. Lahr, Nishant Saran, John M. Stulak, Joseph A. Dearani, Kevin L. Greason, Juan A. Crestanello, and Richard C. Daly
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Male ,Pacemaker, Artificial ,medicine.medical_specialty ,Heart Ventricles ,medicine.medical_treatment ,Cardiac Valve Annuloplasty ,Interquartile range ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Propensity Score ,Aged ,Retrospective Studies ,Tricuspid valve ,business.industry ,Hazard ratio ,Atrial fibrillation ,General Medicine ,Odds ratio ,Middle Aged ,Implantable cardioverter-defibrillator ,medicine.disease ,Tricuspid Valve Insufficiency ,Treatment Outcome ,medicine.anatomical_structure ,Echocardiography ,Ventricular Function, Right ,Cardiology ,Ventricular pressure ,Female ,Tricuspid Valve ,Supraventricular tachycardia ,business ,Follow-Up Studies - Abstract
To evaluate outcomes of elective surgical management of tricuspid regurgitation (TR) in patients with transvenous right ventricular leads, and compare results between non-lead-induced and lead-induced TR patients.We studied patients with right ventricular leads who underwent tricuspid valve surgery from January 1, 1993, through December 31, 2015, and categorized them as non-lead-induced and lead-induced TR. Propensity score (PS) for the tendency to have lead-induced TR was estimated from logistic regression and was used to adjust for group differences.From the initial cohort of 470 patients, 444 were included in PS-adjustment analyses (174 non-lead-induced TRs [123 repairs, 51 replacements], 270 lead-induced TRs [129 repairs, 141 replacements]). In PS-adjusted multivariable analysis, lead-induced TR was not associated with mortality (P=.73), but tricuspid valve replacement was (hazard ratio, 1.59; 95% CI, 1.13 to 2.25; P=.008). Five-year freedom from tricuspid valve re-intervention was 100% for non-lead-induced TR and 92.3% for lead-induced TR; rates adjusted for PS differed between groups (P=.005). There was significant improvement in TR postoperatively in each group (P.001). In patients having tricuspid valve repair, TR grades tended to worsen over time, but the difference in trends was not significantly different between groups.Lead-induced TR did not affect long-term survival after elective tricuspid valve surgery. In patients with lead-induced TR, tricuspid valve re-intervention was more common. Improvement in TR was achieved in both groups after surgery; however, severity of TR tended to increase over follow-up after tricuspid valve repair.
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- 2021
29. Intramyocardial ventricular septal hematoma. Unexpected complication.
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Sandoval, Elena, Ascaso, María, Navarro, Ricard, Quintana, Eduard, and Pereda, Daniel
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Any step in cardiac surgery may have potentially catastrophic consequences. All treatment options need to be carefully evaluated because the most aggressive is not always the best one. We present the case of a 63-year-old man who suffered an interventricular septum hematoma causing left ventricular tract obstruction, secondary to a left ventricular vent. The lesion could be repaired by closing the entry point. [ABSTRACT FROM AUTHOR]
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- 2020
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30. Video-assisted minimally invasive resection of papillary fibroelastoma.
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Sugimura, Yukiharu, Rellecke, Philipp, Reinecke, Petra, Lichtenberg, Artur, and Akhyari, Payam
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Cardiac papillary fibroelastoma is a rare cause of embolic events, especially seen in young patients. A 38-year-old woman with a transient ischemic attack underwent cardiac diagnostic workup. Transesophageal echocardiography and magnetic resonance imaging identified a tumor on the anterior leaflet of the mitral valve as the only potential source of embolization. Video-assisted minimally invasive resection of the tumor and reconstruction of the mitral valve were performed. Postoperative transthoracic echocardiography showed no residual tumor or mitral valve insufficiency. Histology identified a papillary fibroelastoma. The patient was discharged on the 9th postoperative day in good physical condition and without any postoperative limitations. [ABSTRACT FROM AUTHOR]
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- 2020
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31. Aortic and tricuspid valve infective endocarditis caused by Streptococcus suis.
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Miki, Takao, Ohki, Satoshi, Obayashi, Tamiyuki, Yasuhara, Kiyomitsu, Okonogi, Shuichi, and Umeno, Tadashi
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Streptococcus suis is a zoonotic pathogen that causes invasive infections in humans. We report a case of aortic and tricuspid valve infective endocarditis caused by Streptococcus suis, which required cardiac surgery. The patient was a 53-year-old man with high fever and general fatigue for one month. He had been a pig farmer for 30 years. His blood cultures were positive for Streptococcus suis, and transthoracic echocardiography revealed aortic and tricuspid regurgitation with mobile vegetations adhering to the tricuspid valve. We performed aortic valve neo-cuspidization using autologous pericardium, and tricuspid valve replacement using a biological valve. [ABSTRACT FROM AUTHOR]
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- 2019
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32. Commentary: Standardized aortic valve repair in pediatric patients.
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Schäfers HJ
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- Humans, Child, Aortic Valve diagnostic imaging, Aortic Valve surgery, Treatment Outcome, Cardiac Surgical Procedures adverse effects, Aortic Valve Insufficiency, Cardiac Valve Annuloplasty
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- 2023
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33. Functional Insufficiency of Mitral and Tricuspid Valves Associated With Atrial Fibrillation: Impact of Postoperative Atrial Fibrillation Recurrence on Surgical Outcomes.
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Kim K, Kim HJ, Jung SH, Lee J, and Kim JB
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Background and Objectives: To identify the factors associated with adverse outcomes following surgery for functional insufficiency of the mitral valve (MV) or tricuspid valve (TV) associated with atrial fibrillation (AF)., Methods: We evaluated 100 patients (age, 66.5±10.0 years; 47 males) who consecutively underwent surgery for functional insufficiency of the MV or TV associated with AF between January 2000 and December 2020 at our center. The primary outcome was a composite endpoint of all-cause death, valve reoperation, congestive heart failure (CHF) requiring rehospitalization, and stroke., Results: During follow-up (532 patients-years [PYs]), adverse events included death in 16 (3.0%/yr), MV reoperation in 1 (0.2%/yr), CHF in 14 (2.6%/yr), and stroke in 5 (0.9%/yr) patients, demonstrating a 5-year rate of freedom from the primary endpoint of 69.5%. The rate of postoperative AF was high even in those who underwent AF ablation (n=92), with cumulative rates of 48.1% at 1 year and 60.2% at 5 years. In multivariable analyses, the primary outcome was significantly associated with age (adjusted hazard ratio [aHR], 1.06; 95% confidence interval [CI], 1.02-1.10; p=0.005), chronic kidney disease (aHR, 7.76; 95% CI, 2.28-26.38; p=0.001), left atrial appendage exclusion (aHR, 0.35; 95% CI, 0.16-1.78; p=0.010), and postoperative AF as a time-varying covariate (aHR, 3.33; 95% CI, 1.50-7.40; p=0.003)., Conclusion: Among patients undergoing surgery for functional atrioventricular insufficiency associated with AF, a significant proportion showed recurrence of AF over time after concomitant AF ablation, which was significantly associated with poor clinical outcomes., Competing Interests: The authors have no financial conflicts of interest., (Copyright © 2023. The Korean Society of Cardiology.)
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- 2023
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34. Minimally invasive aortic valve repair using geometric ring annuloplasty
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Jordan Llerena‐Velastegui and Marcela Placencia‐Silva
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Pulmonary and Respiratory Medicine ,Heart Valve Prosthesis Implantation ,Treatment Outcome ,Aortic Valve ,Heart Valve Prosthesis ,Aortic Valve Insufficiency ,Humans ,Mitral Valve ,Surgery ,Cardiology and Cardiovascular Medicine ,Cardiac Valve Annuloplasty - Published
- 2022
35. Mitral valve repair and tricuspid annuloplasty for Coffin-Lowry syndrome
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Tatsuto Wakami, Kosuke Yoshizawa, Toshi Maeda, Otohime Mori, and Nobushige Tamura
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Pulmonary and Respiratory Medicine ,Male ,Mitral Valve Annuloplasty ,Adolescent ,Mitral Valve Insufficiency ,General Medicine ,Cardiac Valve Annuloplasty ,Tricuspid Valve Insufficiency ,Treatment Outcome ,Coffin-Lowry Syndrome ,Humans ,Mitral Valve ,Surgery ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine - Abstract
Coffin–Lowry syndrome is a rare X-linked disorder that shows a varied clinical presentation. We report cardiac involvement, particularly abnormalities of mitral valve morphology, in a 14-year-old male adolescent with a known diagnosis of Coffin–Lowry syndrome, who presented with easy fatigability. Echocardiography revealed severe mitral and moderate tricuspid regurgitation, and the papillary muscles were attached to the base of the left ventricle. We performed tricuspid annuloplasty and mitral valve repair using two artificial chordae and a semi-rigid full ring. The patient's postoperative course was uneventful. Postoperative echocardiography revealed reduced mitral regurgitation, and his cardiac failure improved.
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- 2022
36. Concomitant tricuspid annuloplasty in patients with mild to moderate tricuspid valve regurgitation undergoing mitral valve surgery: meta-analysis
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Yujiro, Yokoyama, Junji, Tsukagoshi, Hisato, Takagi, Hiroo, Takayama, and Toshiki, Kuno
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Heart Valve Prosthesis Implantation ,Mitral Valve Annuloplasty ,Treatment Outcome ,Humans ,Mitral Valve ,Mitral Valve Insufficiency ,Surgery ,General Medicine ,Cardiology and Cardiovascular Medicine ,Cardiac Valve Annuloplasty ,Tricuspid Valve Insufficiency ,Retrospective Studies - Abstract
Clinical effects of concomitant tricuspid annuloplasty (TA) in patients with mild to moderate tricuspid regurgitation at the time of mitral valve surgery (MVS) remains indefinite. We aimed to perform a meta-analysis to determine the long-term clinical and echocardiographic effects of concomitant TA in patients undergoing MVS.MEDLINE and EMBASE were searched through January 2022 to identify randomized controlled trials (RCT) and observational studies with adjusted outcomes that investigated outcomes of concomitant TA versus conservative management for mild to moderate tricuspid regurgitation in patients undergoing MVS.Two RCT and 11 observational studies included in the meta-analysis with a total of 3,953 patients underwent MVS with (N.=1837) or without (N.=2166) concomitant TA. Mean follow-up period ranged from 24 to 115.5 months. MVS with concomitant TA was associated with all-cause mortality (hazard ratio [HR] 1.15; 95% confidence interval [CI]: 0.81-1.55; P=0.34, IConcomitant TA for patients undergoing MVS was associated with similar long-term clinical outcomes compared to MVS alone. However, concomitant TA was associated with a significant reduction in TR progression. Longer follow-up is necessary to assess the effect on further clinical outcomes.
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- 2022
37. Outcomes of valve-sparing surgery in heritable aortic disorders
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Vincent Chauvette, Jolanda Kluin, Laurent de Kerchove, Gebrine El Khoury, Hans-Joachim Schäfers, Emmanuel Lansac, Ismail El-Hamamsy, Cardiothoracic Surgery, ACS - Heart failure & arrhythmias, and ACS - Atherosclerosis & ischemic syndromes
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Pulmonary and Respiratory Medicine ,Reoperation ,Aortic Valve Insufficiency ,General Medicine ,Aneurysm ,Cardiac Valve Annuloplasty ,Pilots ,Treatment Outcome ,Aortic Valve ,Humans ,Surgery ,Registries ,Cardiology and Cardiovascular Medicine ,Heritable aortic disorders ,Aorta ,Valve sparing - Abstract
OBJECTIVES Root reimplantation has been the favoured approach for patients with heritable aortic disorder requiring valve-sparring root replacement. In the past few years, root remodelling with annuloplasty has emerged as an alternative to root reimplantation in the general population. The aim of this study was to examine the late outcomes of patients with heritable aortic disorder undergoing valve-sparring root replacement and compare different techniques. METHODS Using the AVIATOR registry (Aortic Valve Insufficiency and ascending aorta Aneurysm InternATiOnal Registry), data were collected from 5 North American and European centres. Patients were divided into 4 groups according to the technique of valve-sparing used (root reimplantation, root remodelling with ring annuloplasty, root remodelling with suture annuloplasty and root remodelling alone). The primary endpoints were freedom from aortic regurgitation (AR) ≥2 and freedom from reintervention on the aortic valve. Secondary endpoints were survival and changes in annular dimensions over time. RESULTS A total of 237 patients were included in the study (reimplantation = 100, remodelling + ring annuloplasty = 76, remodelling + suture annuloplasty = 34, remodelling alone = 27). The majority of patients had Marfan syndrome (83%). Preoperative AR ≥2 was present in 41% of the patients. Operative mortality was 0.4% (n = 1). No differences were found between techniques in terms of postoperative AR ≥2 (P = 0.58), reintervention (P = 0.52) and survival (P = 0.59). Changes in aortic annulus dimension were significantly different at 10 years (P CONCLUSIONS Overall, valve-sparring root replacement is a safe and durable procedure in patients with heritable aortic disorder. Nevertheless, root remodelling alone is associated with late annular dilatation. The addition of an annuloplasty, however, results in similar freedom from AR, reintervention, survival and changes in annulus size compared to reimplantation.
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- 2022
38. Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
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Xavier Galloo, Jan Stassen, Steele C Butcher, Maria Chiara Meucci, Marlieke F Dietz, Bart J A Mertens, Edgard A Prihadi, Pieter van der Bijl, Nina Ajmone Marsan, Jerry Braun, Jeroen J Bax, Victoria Delgado, Cardio-thoracic surgery, and Cardiology
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Pulmonary and Respiratory Medicine ,Heart Failure ,Male ,Ventricular Dysfunction, Right ,General Medicine ,Middle Aged ,Prognosis ,Cardiac Valve Annuloplasty ,Tricuspid Valve Insufficiency ,Tricuspid valve surgery ,Treatment Outcome ,Humans ,Surgery ,Female ,Right heart failure ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
OBJECTIVES This study evaluated the prognostic value of staging right heart failure in patients with significant tricuspid regurgitation (TR) undergoing tricuspid valve (TV) surgery. METHODS Patients with significant TR who underwent TV surgery were divided into 4 right heart failure stages according to the presence of right ventricular (RV) dysfunction and clinical signs of right heart failure: stage 1 was defined as no RV dysfunction and no signs of right heart failure; stage 2 indicated RV dysfunction without signs of right heart failure; stage 3 included RV dysfunction and signs of right heart failure; and stage 4 was defined as RV dysfunction and refractory signs of right heart failure at rest. RESULTS A total of 278 patients [mean age 64 (12), 49% males] were included, of whom 34 (12%) patients were classified as stages 1 and 2, 141 (51%) as stage 3 and 103 (37%) as stage 4 right heart failure. The majority of patients (91%) had TV surgery concomitant to left-sided valve surgery or coronary artery bypass grafting and 95% underwent TV annuloplasty. Cumulative survival rates were 89%, 78% and 61% at 1 month, 1 year and 5 years, respectively. Stages 1 and 2 and stage 3 were independently associated with better survival compared to stage 4 (hazard ratio: 0.391 [95% confidence interval: 0.186–0.823] and 0.548 [95% confidence interval: 0.369–0.813], respectively). CONCLUSIONS Patients with significant TR undergoing TV surgery and diagnosed without advanced right heart failure have better survival as compared to patients with right heart failure.
- Published
- 2022
39. Technik der Trikuspidalklappenrekonstruktion.
- Author
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Moritz, A.
- Abstract
Copyright of Zeitschrift für Herz-, Thorax- und Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
- Full Text
- View/download PDF
40. Leitlinie 'Management von Herzklappenerkrankungen' der EACTS und ESC - Version 2017.
- Author
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Sündermann, S. and Falk, V.
- Abstract
Copyright of Zeitschrift für Herz-, Thorax- und Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
- Full Text
- View/download PDF
41. Katheterinterventionelle Therapie der Trikuspidalklappeninsuffizienz.
- Author
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Wißt, T., Kreidel, F., Schlüter, M., Kuck, K.-H., and Frerker, C.
- Abstract
Copyright of Der Internist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
- Full Text
- View/download PDF
42. Concomitant Tricuspid Annuloplasty in Patients Undergoing Totally Endoscopic Mitral Valve Surgery: A Propensity-Score Matched Analysis
- Author
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Liang-Wan Chen, Xiao-Fu Dai, Ling-chen Huang, and Dao-zhong Chen
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Heart Valve Diseases ,Cardiac Valve Annuloplasty ,law.invention ,law ,medicine ,Humans ,Propensity Score ,Adverse effect ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,business.industry ,Mortality rate ,Endoscopy ,Retrospective cohort study ,General Medicine ,Perioperative ,Middle Aged ,Intensive care unit ,Surgery ,Treatment Outcome ,Echocardiography ,Median sternotomy ,Concomitant ,Propensity score matching ,Mitral Valve ,Female ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background: We aimed to evaluate the clinical outcomes of concomitant tricuspid annuloplasty (TAP) in patients undergoing totally endoscopic mitral valve surgery. Methods: It is a single-center, retrospective study that enrolled a total of 173 patients who underwent mitral valve surgery combined with tricuspid annuloplasty between January 2019 and June 2020 in our institution. Patients who underwent totally endoscopic mitral valve surgery with concomitant tricuspid annuloplasty were categorized into the MIMVS-TAP group (N = 51), and patients who underwent mitral valve surgery with concomitant tricuspid annuloplasty through a median sternotomy were categorized into the MVS-TAP group (N = 122). The data collected included detailed demographic and perioperative data. Each patient in the MIMVS-TAP group was individually matched to a patient in the MVS-TAP group, using the propensity scores, and we obtained a matched sample of 51 patients in each group. Parametric and nonparametric tests were used to analyze outcomes. Results: There were no differences in death rates or related major adverse events between the two groups after propensity score matched analysis. The total operation time was longer in the MIMVS + TAP group versus the MVS+TAP group, as were the mean duration of cardiopulmonary bypass time and the cross-clamp time. The mean duration of intensive care unit stay was longer in the MVS + TAP group compared with that of the MIMVS + TAP group, as was the duration of post-operative hospital stay. Conclusions: Totally endoscopic mitral valve surgery with concomitant tricuspid annuloplasty can improve a patient’s prognosis, with comparable short-term outcomes to those of the open approaches.
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- 2021
43. The best approach for functional tricuspid regurgitation: A network meta-analysis
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Roberto Lorusso, Fabrizio Ricci, Stefano Guarracini, Umberto Benedetto, Antonio M. Calafiore, Giorgia Bonalumi, Justine M. Ravaux, Michele Di Mauro, and Alessandro Parolari
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,suture annuloplasty ,Valve surgery ,Network Meta-Analysis ,tricuspid annuloplasty ,tricuspid valve repair ,030204 cardiovascular system & hematology ,Cardiac Valve Annuloplasty ,03 medical and health sciences ,0302 clinical medicine ,Tricuspid annuloplasty ,Functional tricuspid regurgitation ,Internal medicine ,medicine ,Humans ,tricuspid regurgitation ,Heart Valve Prosthesis Implantation ,Surgical approach ,business.industry ,Ring annuloplasty ,Bayes Theorem ,Gold standard (test) ,rigid ring ,Tricuspid Valve Insufficiency ,Treatment Outcome ,030228 respiratory system ,Heart Valve Prosthesis ,Meta-analysis ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,After treatment ,flexible ring - Abstract
Objective For many years, functional tricuspid regurgitation (FTR) was considered negligible after treatment of left-sided heart valve surgery. The aim of the present network meta-analysis is to summarize the results of four approaches to establish the possible gold standard. Methods A systematic search was performed to identify all publications reporting the outcomes of four approaches for FTR, not tricuspid annuloplasty (no TA), suture annuloplasty (SA), flexible (FRA), rigid rings (RRA). All studies reporting at least one the four endpoints (early and late mortality, early and late moderate or more TFR) were included in a Bayesian network meta-analysis. Results There were 31 included studies with 9663 patients. Aggregate early mortality was 5.3% no TA, 7.2% SA, 6.6% FRA, and 6.4% RRA; early TR moderate-or-more was 9.6%, 4.8%, 4.6%, and 3.8%; late mortality was 22.5%, 18.2%, 11.9%, and 11.9%; late TR moderate-or-more was 27.9%, 18.3%, 14.3%, and 6.4%. Rigid or semirigid ring annuloplasty was the most effective approach for decreasing the risk of late moderate or more FTR (-85% vs. no TA; -64% vs. SA; -32% vs. FRA). Concerning late mortality, no significant differences were found among different surgical approaches; however, flexible or rigid rings reduced significantly the risk of late mortality (78% and 47%, respectively) compared with not performing TA mortality. No differences were found for early outcomes. Conclusions Ring annuloplasty seems to offer better late outcomes compare to either suture annuloplasty or not performing TA. In particular rigid or semirigid rings provide more stable FTR across time.
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- 2021
44. Durability of suture versus ring tricuspid annuloplasty: Looking at very long term (18 years)
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Benedetto Del Forno, Elisabetta Lapenna, Michele De Bonis, Davide Carino, Ottavio Alfieri, Alessandro Verzini, Davide Schiavi, Stefania Ruggeri, Alessandro Castiglioni, Alessandra Sala, and Edoardo Zancanaro
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,Ring (chemistry) ,Cardiac Valve Annuloplasty ,03 medical and health sciences ,0302 clinical medicine ,Tricuspid annuloplasty ,Suture (anatomy) ,medicine ,Humans ,030212 general & internal medicine ,TRICUSPID VALVE REPAIR ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,Tricuspid valve ,Sutures ,business.industry ,Ring annuloplasty ,General Medicine ,Tricuspid Valve Insufficiency ,Surgery ,Death ,Treatment Outcome ,medicine.anatomical_structure ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Several papers already reported better outcomes of tricuspid valve repair with ring annuloplasty compared to suture techniques. However, the follow-up is usually limited to 10 years. With this study, we aim to analyze the results of tricuspid valve repair according to the technique employed when the follow-up is extended to more than 15 years. Materials and methods A retrospective review of our institutional database was carried on to find all patients who underwent tricuspid valve repair between January 1998 and December 2004. Kaplan–Meier method was employed to estimate survival and log-rank test was used to make intergroup comparison. Cox regression was employed to identify risk factor for mortality. Cumulative incidence function using death as competitive outcome was used to estimate cardiac death. To describe the time course of tricuspid regurgitation, a longitudinal analysis using generalized estimating equations with random intercept for correlated data was performed. Results One hundred forty-six patients were identified: 89 in the suture group and 57 in the ring group. No difference in term of long-term survival and cardiac death was evident between the two groups. A significant higher rate of tricuspid regurgitation ≥2+ and ≥3+ recurrence was evident in the suture group during the whole follow-up (p Conclusion Our results corroborate the better results of tricuspid valve repair by means of ring implantation compared to suture techniques also when the follow-up is extended up to 18 years. Ring annuloplasty should be considered the first option for tricuspid valve repair due to a better durability.
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- 2021
45. Diagnóstico y seguimiento de la insuficiencia tricuspídea severa mediante ecocardiografía
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Alonso Cuenca, Rosa María, Martín de La Fuente, Pilar, Moreno Escobar, Eduardo, Alonso Cuenca, Rosa María, Martín de La Fuente, Pilar, and Moreno Escobar, Eduardo
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- 2022
46. Bicuspidized De Vega for Functional Tricuspid Valve Regurgitation: “De-Kay Repair”
- Author
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Grandinetti, M., Bruno, P., Farina, Piero, Pasquini, Annalisa, Pavone, Natalia, Massetti, Massimo, Farina P., Pasquini A., Pavone N., Massetti M. (ORCID:0000-0002-7100-8478), Grandinetti, M., Bruno, P., Farina, Piero, Pasquini, Annalisa, Pavone, Natalia, Massetti, Massimo, Farina P., Pasquini A., Pavone N., and Massetti M. (ORCID:0000-0002-7100-8478)
- Abstract
Functional tricuspid valve regurgitation in the contest of mitral valve disease is a highly prevalent disease. We describe a ringless technique that combines restrictive annuloplasty (De Vega) with posterior tricuspid leaflet obliteration (Kay) used for patients with less-than-severe functional tricuspid valve regurgitation undergoing mitral valve surgery. The technique has been in use at our center since 2012, showing promising long-term echocardiographic results, with stable reduction of the annulus size and stable reduction of the degree of regurgitation.
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- 2022
47. Discussion
- Author
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Stephen H, McKellar
- Subjects
Reoperation ,Pulmonary and Respiratory Medicine ,Long Term Adverse Effects ,Survival Analysis ,Cardiac Valve Annuloplasty ,Outcome and Process Assessment, Health Care ,Postoperative Complications ,Bicuspid Aortic Valve Disease ,Aortic Valve ,Replantation ,Humans ,Surgery ,Cardiology and Cardiovascular Medicine ,Organ Sparing Treatments - Published
- 2022
48. Transcatheter Tricuspid Annulus Reconstruction: Compelling and Complex
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Georg, Nickenig and Atsushi, Sugiura
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Heart Valve Prosthesis Implantation ,Treatment Outcome ,Humans ,Cardiac Valve Annuloplasty ,Tricuspid Valve Insufficiency - Published
- 2022
49. The right heart and outcomes of tricuspid valve surgery
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Rebecca T Hahn
- Subjects
Pulmonary and Respiratory Medicine ,Heart Failure ,Humans ,Surgery ,General Medicine ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,Cardiac Valve Annuloplasty ,Tricuspid Valve Insufficiency - Published
- 2022
50. Impact of reductive tricuspid ring annuloplasty on right ventricular size, geometry and strain in an ovine model of functional tricuspid regurgitation
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Artur Iwasieczko, Marcin Malinowski, Monica Solarewicz, Jared Bush, Brian MacDougall, Manuel Rausch, and Tomasz A Timek
- Subjects
Pulmonary and Respiratory Medicine ,Male ,Sheep ,Echocardiography ,Heart Ventricles ,Animals ,Mitral Valve ,Surgery ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,Cardiac Valve Annuloplasty ,Tricuspid Valve Insufficiency - Abstract
OBJECTIVES Reductive ring annuloplasty of the tricuspid annulus represents the contemporary surgical approach to functional tricuspid regurgitation (FTR). We set out to investigate the influence of moderate reductive tricuspid ring annuloplasty on tricuspid regurgitation and right ventricular (RV) size, geometry and strain in an ovine model of chronic FTR. METHODS Eight healthy Dorsett male sheep (62.8 + 2kg) underwent a left thoracotomy for placement and tightening of pulmonary artery band to at least double proximal pulmonary artery blood pressure. After 8 weeks of recovery, animals underwent sternotomy, epicardial echocardiography and sonomicrometry crystal implantation. Six crystals were placed around tricuspid annulus and 13 on RV free wall epicardium along 3 parallels defining 3 wall regions (basal, mid and lower) and 1 on the RV apex. All animals underwent beating heart implantation of 26 mm MC3 annuloplasty ring during a second cardiopulmonary bypass run after baseline data acquisition. Simultaneous haemodynamic, sonomicrometry and echocardiography data were acquired at Baseline and after reductive tricuspid ring annuloplasty. RESULTS Implantation of reductive ring annuloplasty resulted in 47 ± 7% annular area reduction (996 ± 152 mm vs 516 ± 52 mm2, P = 0.0002) and significantly decreased RV end-diastolic volume (185 ± 27 vs 165 ± 30 ml, P = 0.02). Tricuspid ring annuloplasty effectively reduced FTR grade (3.75 ± 0.6 vs 0.3 ± 0.5, P = 0.00004) and had little influence on RV function, cross-sectional area, radius of curvature or free wall regional strains. CONCLUSIONS In adult sheep with 8 weeks of pulmonary artery banding and FTR, tricuspid annulus reduction of 47% with prosthetic ring annuloplasty effectively abolished FTR while maintaining regional RV function and strain patterns.
- Published
- 2022
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