Clinical Effect of Tricuspid Valve Re-operation after Left Cardiac Valve Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FANFu-dong , HEXiao-jun , PANJun , WANGQiang , ZHOUQing ,  WANGDong-jin

Department of Cardiothoracic Surgery, the Affiliated Drum Tower Hospital of Medical School, Nanjing University, Nanjing 210008, P. R. China;

Corresponding author：

WANGDong-jin, Email: njglwdj@126.com

Keywords：

Left cardiac valve surgery; Tricuspid insufficiency; Re-operation

DOI：

10.7507/1007-4848.20160188

Video：

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Objective To evaluate the clinical efficacy of tricuspid valve re-operation after left cardiac valve surgery. Methods We retrospectively analyzed the clinical data of 23 patients underwent tricuspid valve re-operation in the Affiliated Drum Tower Hospital of Medical School, Nanjing University from January 2009 to November 2014. There were 3 males and 20 females with a mean age 53.48±10.79 years ranging from 34 to 71 years. The average body mass index of the 23 patients was 21.77±2.42 kg/m². We followed up all the patients in outpatient department or through telephone for 3 months to 5 years. Results All surgeries were operated under cardiopulmonary bypass. There were 15 patients underwent operation through medisternal incision and 8 patients underwent operation through the fourth intercostal incision of right anterolateral side. The mean operation time was 284.35±56.16 minutes and the mean time of cardiopulmonary bypass was 138.61±46.91 minutes. One patient died postoperatively and 2 patients chose to discharge automatically after operation. The other 20 patients recovered and discharged uneventfully. We followed up the patients for 3 months to 5 years. One patient underwent permanent pacemaker therapy for atrioventricular block, 3 patients accepted pharmaceutical therapy for atrial arrhyttmia, 1 patient underwent re-operation for infectious endocarditis of left cardiac artificial valve. and the follow-up conditions of the rest patients were well. Besides, the follow-up data showed that there was a mild regurgitation in 3 patients underwent tricuspid valve plasty. Conclusion Tricuspid valve re-operation after left cardiac valve surgery can take multiple surgical pathways and strategies. The clinical effect has been proved and the midterm follow-up condition is well, but we still need the long-term follow-up for the further effect.

Citation： FANFu-dong, HEXiao-jun, PANJun, WANGQiang, ZHOUQing, WANGDong-jin. Clinical Effect of Tricuspid Valve Re-operation after Left Cardiac Valve Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(8): 784-787. doi: 10.7507/1007-4848.20160188 Copy

1.	Ong DS, Aertker RA, Clark AN, et al. Radiation-associated valvular heart disease. J Heart Valve Dis, 2013, 22(6):883-892.
2.	Tleyjeh IM, Kashour T, Zimmerman V, et al. The role of valve surgery in infective endocarditis management:a systematic review of observational studies that included propensity score analysis. Am Heart J, 2008, 156(5):901-909.
3.	过常发, 王春生, 赵东, 等.再次心瓣膜置换术105例的临床分析.中国胸心血管外科临床杂志, 2010, 17(5):361-364.
4.	陈文生, 易定华, 郑奇军, 等.复发性心瓣膜病患者再次心瓣膜置换术的临床分析.中国胸心血管外科临床杂志, 2011, 18(1):70-71.
5.	Anyanwu AC, Chikwe J, Adams DH. Tricuspid valve repair for treatment and prevention of secondary tricuspid regurgitation in patients undergoing mitral valve surgery. Curr Cardiol Rep, 2008, 10(2):110-117.
6.	Tornos MP, Rodríguez-Palomares JF, Antunes MJ. Secondary tricu-spid valve regurgitation:a forgotten entity. Heart, 2015, 101(22):1840-1848.
7.	Shiran A, Sagie A. Tricuspid regurgitation in mitral valve disease incidence, prognostic implications, mechanism, and management. J Am Coll Cardiol, 2009, 53(5):401-408.
8.	Di Mauro M, Bivona A, Iacò AL, et al. Mitral valve surgery for func-tional mitral regurgitation:prognostic role of tricuspid regurgitation. Eur J Cardiothorac Surg, 2009, 35(4):635-639.
9.	Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guide-line for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg, 2014, 148(1):e1-132.
10.	Frater R. Tricuspid insufficiency. J Thorac Cardiovasc Surg, 2001, 122(3):427-429.
11.	Bianchi G, Solinas M, Bevilacqua S, et al. Which patient undergoing mitral valve surgery should also have the tricuspid repair? Interact Cardiovasc Thorac Surg, 2009, 9(6):1009-1020.
12.	Matsuyama K, Matsumoto M, Sugita T, et al. Predictors of residual tricuspid regurgitation after mitral valve surgery. Ann Thorac Surg, 2003, 75(6):1826-1828.
13.	Porter A, Shapira Y, Wurzel M, et al. Tricuspid regurgitation late after mitral valve replacement:clinical and echocardiographic evaluation. J Heart Valve Dis, 1999, 8(1):57-62.
14.	Groves PH, Hall RJ. Late tricuspid regurgitation following mitral valve surgery. J Heart Valve Dis, 1992, 1(1):80-86.
15.	Uehara K, Minakata K, Watanabe K, et al. Tricuspid valve repair for severe tricuspid regurgitation due to pacemaker leads. Asian Cardiovasc Thorac Ann, 2016, 24(6):541-545.
16.	潘世伟, 胡盛寿.继发性三尖瓣关闭不全的外科治疗进展.中国胸心血管外科临床杂志, 2012, 19(2):185-188.
17.	McCarthy PM. Evolving Approaches to tricuspid valve surgery:moving to europe? J Am Coll Cardiol, 2015, 65(18):1939-1940.
18.	Buzzatti N, Iaci G, Taramasso M, et al. Long-term outcomes of tricuspid valve replacement after previous left-side heart surgery. Eur J Cardiothorac Surg, 2014, 46(4):713-719.
19.	肖学钧, 张镜芳, 吴若彬, 等.左心瓣膜置换术后远期三尖瓣关闭不全的外科处理.中华胸心血管外科杂志, 2003, 19(5):260-262.
20.	魏大闯, 黄焕雷, 卢聪, 等.左心瓣膜置换术后孤立性三尖瓣关闭不全的外科治疗.中国胸心血管外科临床杂志, 2014, 21(2):178-183.

1. Ong DS, Aertker RA, Clark AN, et al. Radiation-associated valvular heart disease. J Heart Valve Dis, 2013, 22(6):883-892.
2. Tleyjeh IM, Kashour T, Zimmerman V, et al. The role of valve surgery in infective endocarditis management:a systematic review of observational studies that included propensity score analysis. Am Heart J, 2008, 156(5):901-909.
3. 过常发, 王春生, 赵东, 等.再次心瓣膜置换术105例的临床分析.中国胸心血管外科临床杂志, 2010, 17(5):361-364.
4. 陈文生, 易定华, 郑奇军, 等.复发性心瓣膜病患者再次心瓣膜置换术的临床分析.中国胸心血管外科临床杂志, 2011, 18(1):70-71.
5. Anyanwu AC, Chikwe J, Adams DH. Tricuspid valve repair for treatment and prevention of secondary tricuspid regurgitation in patients undergoing mitral valve surgery. Curr Cardiol Rep, 2008, 10(2):110-117.
6. Tornos MP, Rodríguez-Palomares JF, Antunes MJ. Secondary tricu-spid valve regurgitation:a forgotten entity. Heart, 2015, 101(22):1840-1848.
7. Shiran A, Sagie A. Tricuspid regurgitation in mitral valve disease incidence, prognostic implications, mechanism, and management. J Am Coll Cardiol, 2009, 53(5):401-408.
8. Di Mauro M, Bivona A, Iacò AL, et al. Mitral valve surgery for func-tional mitral regurgitation:prognostic role of tricuspid regurgitation. Eur J Cardiothorac Surg, 2009, 35(4):635-639.
9. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guide-line for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg, 2014, 148(1):e1-132.
10. Frater R. Tricuspid insufficiency. J Thorac Cardiovasc Surg, 2001, 122(3):427-429.
11. Bianchi G, Solinas M, Bevilacqua S, et al. Which patient undergoing mitral valve surgery should also have the tricuspid repair? Interact Cardiovasc Thorac Surg, 2009, 9(6):1009-1020.
12. Matsuyama K, Matsumoto M, Sugita T, et al. Predictors of residual tricuspid regurgitation after mitral valve surgery. Ann Thorac Surg, 2003, 75(6):1826-1828.
13. Porter A, Shapira Y, Wurzel M, et al. Tricuspid regurgitation late after mitral valve replacement:clinical and echocardiographic evaluation. J Heart Valve Dis, 1999, 8(1):57-62.
14. Groves PH, Hall RJ. Late tricuspid regurgitation following mitral valve surgery. J Heart Valve Dis, 1992, 1(1):80-86.
15. Uehara K, Minakata K, Watanabe K, et al. Tricuspid valve repair for severe tricuspid regurgitation due to pacemaker leads. Asian Cardiovasc Thorac Ann, 2016, 24(6):541-545.
16. 潘世伟, 胡盛寿.继发性三尖瓣关闭不全的外科治疗进展.中国胸心血管外科临床杂志, 2012, 19(2):185-188.
17. McCarthy PM. Evolving Approaches to tricuspid valve surgery:moving to europe? J Am Coll Cardiol, 2015, 65(18):1939-1940.
18. Buzzatti N, Iaci G, Taramasso M, et al. Long-term outcomes of tricuspid valve replacement after previous left-side heart surgery. Eur J Cardiothorac Surg, 2014, 46(4):713-719.
19. 肖学钧, 张镜芳, 吴若彬, 等.左心瓣膜置换术后远期三尖瓣关闭不全的外科处理.中华胸心血管外科杂志, 2003, 19(5):260-262.
20. 魏大闯, 黄焕雷, 卢聪, 等.左心瓣膜置换术后孤立性三尖瓣关闭不全的外科治疗.中国胸心血管外科临床杂志, 2014, 21(2):178-183.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Effect of Tricuspid Valve Re-operation after Left Cardiac Valve Surgery

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