Prosthetic valve surgery in tricuspid area

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease

Background:

• Valvular heart disease treatment is a significant area in cardiovascular surgery.
• Surgical interventions for tricuspid valve disease aim to restore normal heart function and hemodynamics.

Purpose of the Study:

• To evaluate the outcomes of tricuspid valve replacement (TVR) and tricuspid annuloplasty (TAP) for valvular heart diseases.
• To introduce and assess a novel annuloplasty technique, Circumferential Annular Constriction.

Main Methods:

• Retrospective analysis of 33 tricuspid valve surgical cases (27 replacements, 6 annuloplasties) from Sapporo Medical University Hospital (up to Sept 1975).
• Comparison of hemodynamic improvements and postoperative complications between TVR and TAP.
• Description of the novel 'Circumferential Annular Constriction' annuloplasty technique using paired purse-string sutures.

Main Results:

• Tricuspid valve surgery, including TVR, improved hemodynamic conditions in patients with tricuspid regurgitation (TI).
• Postoperative atrioventricular (A-V) block and sinus bradycardia were significant complications of TVR.
• Long-term hemodynamic results of TAP were comparable to TVR.

Conclusions:

• While TVR improves hemodynamics, its associated complications necessitate alternative approaches.
• Tricuspid annuloplasty, particularly with improved techniques, offers comparable long-term hemodynamic results to TVR.
• The 'Circumferential Annular Constriction' technique shows promise for achieving effective annular constriction similar to ring materials.