The application of minimally invasive tricuspid valvuloplasty technique with patch augmentation in reoperative cardiac surgery
10.7507/1007-4848.201803028
- VernacularTitle:微创三尖瓣补片扩大成形用于再次心脏手术
- Author:
KE Yingjie
1
,
2
;
CHEN Zerui
3
;
HUANG Huanlei
3
;
ZENG Qingshi
3
;
GUO Huiming
3
;
HUANG Jingsong
3
;
LIU Jing
3
;
LIU Jian
3
;
ZHANG Xiaohua
3
;
LU Cong
3
Author Information
1. 1. Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, P.R.China
2. 2. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, P.R.China
3. Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, P.R.China
- Publication Type:Journal Article
- Keywords:
Minimally invasive surgery;
tricuspidplasty;
reoperative cardiac surgery;
tricuspid leaflets augmentation
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(7):577-582
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of a combination of beating-heart minimally invasive approach and leaflets augmentation technique treating severe tricuspid regurgitation (TR) after cardiac surgery. Methods From January 2015 to August 2017, patients undergoing reoperative tricuspid valve repair (TVP) with minimally invasive approach and leaflets augmentation were enrolled. Cardiopulmonary bypass (CPB) was established via femoral vessels and the procedures were performed on beating heart with normothermic CPB. A bovine pericardial patch was sutured to leaflets to augment the native anterior and posterior leaflets. Other repair techniques, such as ring implantation and leaflet mobilization, were also applied as needed. Results A total of 28 patients (mean age 55.6±10.1 years, 5 males, 23 females) were enrolled. One patient was converted to median sternotomy due to pleural cavity adhesion. Twenty-seven patients underwent totally endoscopic TVP with leaflets augmentation. No patients was transferred to tricuspid valve replacement. Two patients died in hospital. All patients were followed up for 7.4±5.0 months and there was no late death and reoperation. Regurgitation area was converted from 20.7±10.1 cm2 to 3.3±3.3 cm2 after TVP according to the latest echocardiography (P<0.001). Conclusion Minimally TVP with leaflets augmentation is effective in treating severe isolated TR after primary cardiac surgery. It can significantly increase success rate of tricuspid valvuloplasty and decrease the surgical trauma.
