Back to 2015 Annual Meeting Display Posters

OBJECTIVE: Right ventricular dysfunction associated with tricuspid valve regurgitation is correlated with higher operative risk. We aimed to identify outcome differences in patients (pts) with tricuspid valve repair (TVR) either beating heart or with the heart arrested in conjunction with mitral surgery.
METHODS: We retrospectively analyzed our hospital data of TVR and concomitant mitral valve surgery from 01/09 until 12/11 in 58 pts. Group 1 (n=25) underwent beating heart TVR, group 2 (n=33) had TVR with the heart arrested. Both groups were compared regarding pre and post interventional data and resulting tricuspid valve function. Tricuspid valve annuloplasty was performed with rigid rings in most cases. A few pts received a flexible band.
RESULTS: There was no difference in preoperative data (gender, age, EuroScore II, LV function). Obviously, x-clamp and bypass time were longer in group 2. Tricuspid valve function was similar after 1 year (insufficiency grade I and better: 20 pts. in group I vs. 27 pts. in group 2). Permanent pacemaker implantation was more common in the arrested heart group 2 (6 (18%) vs. 0 in group 1, p=0.024). Only 2 pts. had additional biatrial ablation procedures for atrial fibrillation and 5 in group 2. Long-term freedom from cardiac death was in the beating heart TVR group 88% vs. group 2 71%, p=0,13 respectively.
CONCLUSIONS: TVR plus mitral valve surgery with the heart arrested is associated with a higher incidence of permanent pacemaker implantation and worse freedom from cardiac death than TVR on a beating heart. Beating heart TVR should be preferred to arrested heart TVR in order to decrease the incidence of permanent pacemaker implantation.