Background: Isolated tricuspid valve surgery has been associated with early mortality rates of up to 10%. With rapidly emerging interventional catheter-based options, the question arises whether current technical and perioperative protocols in cardiac surgery translate into lower than previously expected mortality rates, especially when looking at data from high-volume centers.
Methods: We performed a retrospective single-center analysis in 369 patients undergoing isolated tricuspid valve repair ( = 256) or replacement ( = 113) between 2009 and 2021. Surgical approaches included full sternotomy, as well as right-sided minithoracotomy. According to a recently introduced clinical risk score, patients were divided into scoring groups, and observed (O) versus expected (E) early mortality were compared. Pre- and postoperative tricuspid valve function was also analyzed.
Results: Overall, 30-day mortality was 4.1%, ranging from 0% (scoring group 0-1 points) to 8.7% (scoring group ≥ 10 points), which was substantially lower than the expected early mortality (2% in the lowest to 34% in the highest scoring group). Preoperative tricuspid regurgitation was severe in 71.3% ( = 263), moderate to severe in 14.9% ( = 55), and mild or less in 6.5% ( = 24). The corresponding postoperative values were 0% ( = 0), 1.4% ( = 5), and 81.6% ( = 301).
Conclusion: Our high-volume center data indicate substantially lower than predicted 30-day mortality in different cardiac surgical risk scoring groups. The majority of patients had zero to minimal residual tricuspid valve insufficiency postoperatively. Randomized controlled trials are needed to compare tricuspid valve functional results and long-term outcomes of surgical versus interventional procedures in patients undergoing isolated tricuspid valve procedures.
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http://dx.doi.org/10.1055/a-2048-8199 | DOI Listing |
Ultrasound J
January 2025
Pediatric Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, CT, 06511, USA.
E-point septal separation (EPSS) and tricuspid annular plane systolic excursion (TAPSE) are M-mode measures of left and right ventricular systolic function, with limited pediatric point-of-care ultrasound (POCUS) research. We conducted a cross-sectional study in a pediatric emergency department, enrolling 12-17-year-olds without cardiopulmonary complaints. Exclusion criteria included abnormal vital signs, fever, altered mental status, or psychiatric illness.
View Article and Find Full Text PDFJACC Cardiovasc Interv
January 2025
Structural Heart Program, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Zhonghua Er Ke Za Zhi
January 2025
Heart Center, Women and Children's Hospital, Qingdao University, Qingdao266034, China.
To evaluate the clinical efficacy of percutaneous balloon pulmonary valvuloplasty (PBPV) via antegrade venous-arterial loop in neonates with critical pulmonary stenosis with intact ventricular septum (CPS-IVS). A retrospective case review was conducted. Fifteen neonates with CPS-IVS who underwent PBPV via antegrade venous-arterial loop at the Women and Children's Hospital, Qingdao University between September 2020 and September 2023 were included.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
January 2025
Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Background: Data supporting the use of transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve (BAV) is limited compared to tricuspid aortic valve (TAV) anatomy, as the BAV anatomy poses unique challenges to prosthesis expansion and symmetric deployment.
Aims: We aim to compare the acute recoil and asymmetry of the SAPIEN-3 valve between BAV and TAV anatomies and their impact on procedural outcomes.
Methods: We conducted a single-center study of patients who underwent TAVR with the SAPIEN-3 valve.
J Am Coll Cardiol
January 2025
Center for Interventional Programs, UCLA Health System, and the UCLA Cardiac Arrhythmia Center & EP Programs David Geffen School of Medicine, Los Angeles, California, USA. Electronic address:
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