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. 2013 Nov;2(6):758-64.
doi: 10.3978/j.issn.2225-319X.2013.10.01.

Concomitant tricuspid valve repair in patients with minimally invasive mitral valve surgery

Bettina Pfannmüller  1 , Piroze Davierwala  1 , Gregor Hirnle  1 , Michael A Borger  1 , Martin Misfeld  1 , Jens Garbade  1 , Joerg Seeburger  1 , Friedrich W Mohr  1
Affiliations

Concomitant tricuspid valve repair in patients with minimally invasive mitral valve surgery

Bettina Pfannmüller et al. Ann Cardiothorac Surg. 2013 Nov.

Abstract

Background: The aim of this study was to investigate the 10-year Leipzig experience with minimally invasive mitral valve (MIMV) surgery in combination with tricuspid valve (TV) surgery.

Methods: Between January 2002 and December 2011, a total of 441 patients with mitral valve (MV) dysfunction and concomitant TV regurgitation (TR) underwent MIMV surgery at the Leipzig Heart Center. The mean age was 68.7±10.0 years, mean LVEF was 56.7%±13.1% and 184 patients (41.7%) were male. The Average logEuroSCORE was 8.3%±7.2%, and patients had an average follow-up of 3.4±2.4 years.

Results: Pre-discharge echocardiography showed no or mild mitral regurgitation (MR) in 95.1% and no or mild TR in 84.1%. Overall 30-day mortality was 4.3% with nineteen deaths. Five-year survival was 77.2%±2.5%. Five-year freedom from TV-related reoperation was 91.0%±1.8%.

Conclusions: Our 10-year experience show that MIMV surgery in combination with TV surgery can be performed routinely with good peri- and post-operative results. Our observations support current recommendations to perform concomitant TV repair, particularly if tricuspid annular dilation is present.

Keywords: Tricuspid valve (TV); minimally invasive surgery; mitral valve (MV).

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Figures

Figure 1
Figure 1
Proportion of patients undergoing MIMV with concomitant tricuspid valve (TV) repair over time.
Figure 2
Figure 2
(A) Tricuspid regurgitation (TR) grade on preoperative and predischarge echocardiography; (B) Mitral regurgitation grade on preoperative and predischarge echocardiography.
Figure 3
Figure 3
(A) Kaplan-Meier estimated survival for all patients; (B) Kaplan-Meier estimated survival for patients with preoperative TR ≤2 vs. TR >2.
Figure 4
Figure 4
Kaplan-Meier estimated freedom from reoperation.
See this image and copyright information in PMC

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