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Partial replacement of tricuspid valve using cryopreserved homograft
Bishwo M S Shrestha1, Satsuki Fukushima, Marian Vrtik
1Division of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Australia. bishwo_shrestha@health.qld.gov.au
Background:
The optimal choice of prosthesis for tricuspid valve (TV) replacement is yet to be determined. Partial replacement of the TV using a homograft atrioventricular valve might offer resistance to infection, good durability, and excellent functionality, in addition to avoiding prosthesis-related morbidity.
Methods:
We present 14 patients who underwent replacement of the TV using a homograft between 1997 and 2008. The mean age at operation was 32 years, including 5 patients younger than the age of 10. All patients preoperatively showed severe TV regurgitation as a result of active infective endocarditis in 5 patients, Ebstein anomaly in 4 patients, other cardiac anomalies in 4 patients, and rheumatic valvular disease in 1 patient. The TV homograft was used in 13 patients, and mitral homograft was used in 1 patient. Eleven patients had replacement of one leaflet only, whereas 3 patients required replacement of two leaflets. Concomitant cardiac procedures were performed in 7 patients.
Results:
No mortalities occurred during the average postoperative follow-up of 61 months (range, 12 to 126 months). Reoperation for TV regurgitation after TV repair with homograft was performed in 3 patients. The remaining 11 patients had minimal symptoms without reintervention for TV regurgitation.
Conclusions:
Partial replacement of the TV using a homograft provided good hospital and mid-term outcomes. This strategy might be useful in active infective endocarditis and congenital TV disease.
