Isolated Tricuspid Valve Repair and Right Atrial Plication Performed Using a Beating-Heart Technique for Atrial Functional Tricuspid Valve Regurgitation  

作　　者：Kayo Sugiyama Hirotaka Watanuki Masato Tochii Daisuke Koiwa Katsuhiko Matsuyama Kayo Sugiyama;Hirotaka Watanuki;Masato Tochii;Daisuke Koiwa;Katsuhiko Matsuyama(Department of Cardiac Surgery, Aichi Medical University Hospital, Nagakute, Japan)

机构地区：[1]Department of Cardiac Surgery, Aichi Medical University Hospital, Nagakute, Japan

出　　处：《Open Journal of Thoracic Surgery》2023年第2期7-16,共10页胸外科期刊（英文）

摘　　要：Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.

关 键 词：Isolated Tricuspid Valve Surgery Beating-Heart Surgery Right Atrial Plication Atrial Functional Tricuspid Valve Regurgitation TRI-SCORE 

分 类 号：R54[医药卫生—心血管疾病]