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. 2024 Oct 1:22:214-221.
doi: 10.1016/j.xjon.2024.09.021. eCollection 2024 Dec.

Is concomitant tricuspid valve repair in patients undergoing robotic mitral valve repair safe and effective?

Phillip G Rowse  1 , Yazan AlJamal  1 , Richard C Daly  1 , Austin Todd  2 , Arman Arghami  1 , Juan A Crestanello  1 , Joseph A Dearani  1
Affiliations

Is concomitant tricuspid valve repair in patients undergoing robotic mitral valve repair safe and effective?

Phillip G Rowse et al. JTCVS Open. .

Abstract

Objectives: Robotic-assisted mitral valve repair (MVr) is a well-established procedure for management of degenerative mitral valve disease. Limited data regarding concomitant robotic-assisted tricuspid valve repair (TVr) is available. This review investigates prevalence and outcomes of concomitant robotic-assisted mitral and tricuspid valve repair.

Methods: From 2014 to 2022, 839 patients underwent robotic-assisted MVr, including 76 patients with moderate or greater tricuspid regurgitation and/or tricuspid annular dilatation ≥40 mm. Among the 76 patients, 19 (25%) underwent isolated MVr and 57 (75%) had concomitant mitral and tricuspid valve repair. Outcome data between the 2 groups were analyzed.

Results: In the MVr/TVr group, tricuspid regurgitation grades were mild in 4 (7%) patients, moderate in 44 (77%) and severe in 9 (15.7%). Significant tricuspid annular dilatation ≥40 mm was present in all patients. In the isolated MVr group, 3 (15.7%) patients had mild tricuspid regurgitation and 16 (84.2%) had moderate tricuspid regurgitation with significant tricuspid annular dilatation present in only 6 patients. Cardiopulmonary bypass and crossclamp time were 130.6 and 91 minutes versus 85 and 55.4 minutes for robotic MVr/TVr group versus MVr group, respectively (P < .05). The intensive care unit and hospital length of stay were similar: 27.7 versus 27.7 hours and 4.4 versus 4.2 days for MVr/TVr versus MVr (P = .24), respectively. There were no perioperative deaths or heart block in either group. Survival and freedom from reoperation with median follow-up of 16 and 46 months for MVr/TVr and MVr groups, respectively were 100%.

Conclusions: Concomitant robotic-assisted tricuspid valve repair for functional regurgitation can be safely and effectively performed at the time of mitral valve repair with excellent short-term morbidity and mortality results.

Keywords: minimally invasive; robotic mitral repair; robotic tricuspid repair.

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Conflict of interest statement

The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest.

Figures

None
Robotic-assisted mitral and tricuspid valve repair.
Figure 1
Figure 1
Severity of tricuspid regurgitation. A, Concomitant mitral valve repair/tricuspid valve repair group. B, Isolated mitral valve repair group. Pre-Op, Preoperative; Post-Op, postoperative.
Figure 2
Figure 2
Ejection fraction of concomitant mitral valve repair/tricuspid valve repair group and isolated mitral valve repair group. Pre-Op, Preoperative; Post-Op, postoperative.
None
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References

    1. Badhwar V., Rankin J.S., He M., et al. Performing concomitant tricuspid valve repair at the time of mitral valve operations is not associated with increased operative mortality. Ann Thorac Surg. 2017;103:587–593. - PubMed
    1. Essayagh B., Antoine C., Benfari G., et al. Functional tricuspid regurgitation of degenerative mitral valve disease: a crucial determinant of survival. Eur Heart J. 2020;41:1918–1929. - PubMed
    1. King R.M., Schaff H.V., Danielson G.K., et al. Surgery for tricuspid regurgitation late after mitral valve replacement. Circulation. 1984;70(3 Pt 2):I193–I197. - PubMed
    1. Staab M.E., Nishimura R.A., Dearani J.A. Isolated tricuspid valve surgery for severe tricuspid regurgitation following prior left heart valve surgery: analysis of outcome in 34 patients. J Heart Valve Dis. 1999;8:857–874. - PubMed
    1. Breyer R.H., McClenathan J.H., Michaelis L.L., et al. Tricuspid regurgitation: a comparison of nonoperative management, tricuspid annuloplasty, and tricuspid valve replacement. J Thorac Cardiovasc Surg. 1976;72:867–874. - PubMed

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