Minimally Invasive Isolated Redo Tricuspid Valve Surgery
Cagdas Baran, Ali Ihsan Hasde, Evren Ozcinar, Mehmet Cakici, Bahadir Inan, Serkan Durdu, Mustafa Sirlak, Levent Yazicioglu, Sadik Eryilmaz, Ruchan Akar, Kemalettin Ucanok.
Ankara University School of Medicine, Ankara, Turkey.
OBJECTIVE: Isolated tricuspid valve (TV) surgery is a high-risk procedure. Although the surgical approach is controversial, we have analyzed our experience with surgical treatment of redo isolated tricuspic valve by minimally invasive procedure.
METHODS: We retrospectively analyzed all patients with previous cardiac surgery who underwent redo-isolated minimally tricuspid valve surgery (IMTVS) (n = 14).
RESULTS: These patients with high-risk group had poor right ventricular functions (TAPSE=12±2.1). The redo-IMTVS approach consisted of a right anterolateral mini-thoracotomy, transpericardial right atrial access, and beating heart TV surgery (Ring annuloplasty n=10 and replacement n=4) with bi-caval occlusion. There were no intraoperative complications or conversions to sternotomy in these patients. There was no need for permanent pace and bleeding-revision rate was 7.1%. 30-day mortality was 7.1%.
CONCLUSION: Minimally invasive, isolated TV surgery as reoperation with caval occlusion and on the beating heart can be safe and may improve clinical outcome.
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