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Minimally Invasive Isolated Tricuspid Valve Surgery Experience At A Single Cente
Walid Al Houssaini Acdhi, Lorena Rubio Lobato, Maria José Mataró López, Jose María Melero Tejedor;
Hospital Universitario Virgen de la Victoria, Málaga, Spain
BACKGROUND: Tricuspid valve disease incidence has been increasing over the last years. When indicated, tricuspid valve surgery through median sternotomy has raised concerns regarding its morbidity and mortality. In such background, isolated tricuspid minimally invasive surgery program through right anterior minithoracotomy has been progressively implemented to improve outcomes.
METHODS: A case series of 29 patients who underwent minimally invasive isolated tricuspid valve surgery in our center, from 2014 to 2023, have been studied retrospectively. Levosimendan had been administered preoperatively in patients with pulmonary hypertension and/or right ventricular dysfunction.
RESULTS: 28 tricuspid valve replacements and one repair were performed. 18 patients had previous cardiac surgery. Average Euroscore II was 3.84. In-hospital mortality was 3.4% (one patient). Average extracorporeal circulation was 109 minutes. There was a reoperation due bleeding (3.4%) and a permanent pacemaker implantation (3.4%). The need for hemodyalisis was 21% (6 patients). The median hospital stay was 7 days.
CONCLUSIONS: Minimally invasive isolated tricuspid valve surgery is a safe technique as a definitive treatment of isolated tricuspid valve disease with a low mortality and morbidity.
Preoperative data| Average age, years | 63 |
| Age range, years | 42-77 |
Women n, %
Men n, % | 22 (76)7 (24) |
| Risk Factors n, %:Atrial fibrilation | 29 (100) |
| Previous cardiac surgery | 18 (62) |
| Right ventricular dysfunction | 12 (41) |
| Previous pacemaker | 5 (17) |
| Chronic kidney disease | 4 (14) |
| Preoperative levosimendan | 22 (76) |
| Pulmonary hypertension | 5 (17) |
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