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Combined Valve Operations in the Aortic and Mitral Positions With or Without Added Tricuspid Valve Repair
There is limited clinical evidence on when to address tricuspid regurgitation in patients with aortic and mitral valve disease requiring surgical intervention. In this study, we aimed to investigate the potential added value of performing a tricuspid valve repair concomitantly in patients requiring...
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| Published in: | Seminars in thoracic and cardiovascular surgery 2020-01, Vol.32 (4), p.665-672 |
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| container_title | Seminars in thoracic and cardiovascular surgery |
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| creator | Faggion Vinholo, Thais Mori, Makoto Mahmood, Syed Usman Bin Mullan, Clancy W. Weininger, Gabe Yousef, Sameh Geirsson, Arnar |
| description | There is limited clinical evidence on when to address tricuspid regurgitation in patients with aortic and mitral valve disease requiring surgical intervention. In this study, we aimed to investigate the potential added value of performing a tricuspid valve repair concomitantly in patients requiring double valve surgery (DVS) of the aortic and mitral valves. We reviewed 223 cases of multivalve surgery from 2011 to 2016. In this single-institution series, 190 underwent DVS in aortic and mitral positions and 33 had triple valve surgery in aortic, mitral, and tricuspid positions. Preoperative and postoperative echocardiograms were evaluated to determine changes in valve function. A logistic regression model was performed to assess relationship of patient comorbidities and type of valve operations to perioperative adverse events. Mid-term survival was similar between the 2 groups (P = 0.541). Compared to DVS, TVS was not associated with an increased risk of perioperative adverse events, including need for pacemaker or mortality on multivariable analysis. Within the DVS subgroup, 19.8% of patients experienced improvement in tricuspid valve function with decrease in the degree of tricuspid regurgitation within a 6-month postoperative follow-up. Our study indicates that repairing the tricuspid valve while addressing the aortic and mitral valves does not pose significant additional risk. The observed improvement of the degree of tricuspid regurgitation without tricuspid operation suggests the need to further define subpopulations of patients with multivalvular disease.
Tricuspid valve repair while addressing the aortic and mitral valve was not associated with increased risk indicating the safety of performing triple valve surgery. There is a fraction of patients within the DVS group who experienced TR improvement. TR, tricuspid regurgitation; DVS, double valve surgery. [Display omitted] |
| doi_str_mv | 10.1053/j.semtcvs.2020.02.010 |
| format | article |
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Tricuspid valve repair while addressing the aortic and mitral valve was not associated with increased risk indicating the safety of performing triple valve surgery. There is a fraction of patients within the DVS group who experienced TR improvement. TR, tricuspid regurgitation; DVS, double valve surgery. [Display omitted]</description><identifier>ISSN: 1043-0679</identifier><identifier>EISSN: 1532-9488</identifier><identifier>DOI: 10.1053/j.semtcvs.2020.02.010</identifier><identifier>PMID: 32060011</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Aortic Valve - diagnostic imaging ; Aortic Valve - physiopathology ; Aortic Valve - surgery ; Cardiac Surgical Procedures - adverse effects ; Female ; Heart Valve Diseases - diagnostic imaging ; Heart Valve Diseases - physiopathology ; Heart Valve Diseases - surgery ; Hemodynamics ; Humans ; Male ; Middle Aged ; Mitral Valve - diagnostic imaging ; Mitral Valve - physiopathology ; Mitral Valve - surgery ; Multiple valve surgery ; Postoperative Complications - etiology ; Recovery of Function ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Tricuspid valve ; Tricuspid Valve - diagnostic imaging ; Tricuspid Valve - physiopathology ; Tricuspid Valve - surgery ; Triple valve surgery</subject><ispartof>Seminars in thoracic and cardiovascular surgery, 2020-01, Vol.32 (4), p.665-672</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-b937549b17158e8e59364d6473849ec80da615e32aa55a18e81c9b09183b1d833</citedby><cites>FETCH-LOGICAL-c365t-b937549b17158e8e59364d6473849ec80da615e32aa55a18e81c9b09183b1d833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32060011$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Faggion Vinholo, Thais</creatorcontrib><creatorcontrib>Mori, Makoto</creatorcontrib><creatorcontrib>Mahmood, Syed Usman Bin</creatorcontrib><creatorcontrib>Mullan, Clancy W.</creatorcontrib><creatorcontrib>Weininger, Gabe</creatorcontrib><creatorcontrib>Yousef, Sameh</creatorcontrib><creatorcontrib>Geirsson, Arnar</creatorcontrib><title>Combined Valve Operations in the Aortic and Mitral Positions With or Without Added Tricuspid Valve Repair</title><title>Seminars in thoracic and cardiovascular surgery</title><addtitle>Semin Thorac Cardiovasc Surg</addtitle><description>There is limited clinical evidence on when to address tricuspid regurgitation in patients with aortic and mitral valve disease requiring surgical intervention. In this study, we aimed to investigate the potential added value of performing a tricuspid valve repair concomitantly in patients requiring double valve surgery (DVS) of the aortic and mitral valves. We reviewed 223 cases of multivalve surgery from 2011 to 2016. In this single-institution series, 190 underwent DVS in aortic and mitral positions and 33 had triple valve surgery in aortic, mitral, and tricuspid positions. Preoperative and postoperative echocardiograms were evaluated to determine changes in valve function. A logistic regression model was performed to assess relationship of patient comorbidities and type of valve operations to perioperative adverse events. Mid-term survival was similar between the 2 groups (P = 0.541). Compared to DVS, TVS was not associated with an increased risk of perioperative adverse events, including need for pacemaker or mortality on multivariable analysis. Within the DVS subgroup, 19.8% of patients experienced improvement in tricuspid valve function with decrease in the degree of tricuspid regurgitation within a 6-month postoperative follow-up. Our study indicates that repairing the tricuspid valve while addressing the aortic and mitral valves does not pose significant additional risk. The observed improvement of the degree of tricuspid regurgitation without tricuspid operation suggests the need to further define subpopulations of patients with multivalvular disease.
Tricuspid valve repair while addressing the aortic and mitral valve was not associated with increased risk indicating the safety of performing triple valve surgery. There is a fraction of patients within the DVS group who experienced TR improvement. TR, tricuspid regurgitation; DVS, double valve surgery. [Display omitted]</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - physiopathology</subject><subject>Aortic Valve - surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Female</subject><subject>Heart Valve Diseases - diagnostic imaging</subject><subject>Heart Valve Diseases - physiopathology</subject><subject>Heart Valve Diseases - surgery</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - physiopathology</subject><subject>Mitral Valve - surgery</subject><subject>Multiple valve surgery</subject><subject>Postoperative Complications - etiology</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Tricuspid valve</subject><subject>Tricuspid Valve - diagnostic imaging</subject><subject>Tricuspid Valve - physiopathology</subject><subject>Tricuspid Valve - surgery</subject><subject>Triple valve surgery</subject><issn>1043-0679</issn><issn>1532-9488</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqFkE1v1DAQhi0Eoh_wE0A-ckkY23Fin9BqVShSq6KqhaPl2FPVqyQOtrMS_74pu-XKaebwvO9oHkI-MKgZSPF5V2cci9vnmgOHGngNDF6RUyYFr3Sj1Ot1h0ZU0Hb6hJzlvAPgrBPiLTkRHFoAxk5J2MaxDxN6-tMOe6Q3MyZbQpwyDRMtj0g3MZXgqJ08vQ4l2YH-iDkckF-hPNKY_s64FLrxfm26S8EteQ4vnbc425DekTcPdsj4_jjPyf3Xi7vtZXV18-37dnNVOdHKUvVadLLRPeuYVKhQatE2vm06oRqNToG3LZMouLVSWrYizOkeNFOiZ14JcU4-HXrnFH8vmIsZQ3Y4DHbCuGTDhZS67bhSKyoPqEsx54QPZk5htOmPYWCeLZudOVo2z5YNcLNaXnMfjyeWfkT_L_WidQW-HABcH90HTCa7gJNDHxK6YnwM_znxBP7YkAE</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Faggion Vinholo, Thais</creator><creator>Mori, Makoto</creator><creator>Mahmood, Syed Usman Bin</creator><creator>Mullan, Clancy W.</creator><creator>Weininger, Gabe</creator><creator>Yousef, Sameh</creator><creator>Geirsson, Arnar</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200101</creationdate><title>Combined Valve Operations in the Aortic and Mitral Positions With or Without Added Tricuspid Valve Repair</title><author>Faggion Vinholo, Thais ; 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In this study, we aimed to investigate the potential added value of performing a tricuspid valve repair concomitantly in patients requiring double valve surgery (DVS) of the aortic and mitral valves. We reviewed 223 cases of multivalve surgery from 2011 to 2016. In this single-institution series, 190 underwent DVS in aortic and mitral positions and 33 had triple valve surgery in aortic, mitral, and tricuspid positions. Preoperative and postoperative echocardiograms were evaluated to determine changes in valve function. A logistic regression model was performed to assess relationship of patient comorbidities and type of valve operations to perioperative adverse events. Mid-term survival was similar between the 2 groups (P = 0.541). Compared to DVS, TVS was not associated with an increased risk of perioperative adverse events, including need for pacemaker or mortality on multivariable analysis. Within the DVS subgroup, 19.8% of patients experienced improvement in tricuspid valve function with decrease in the degree of tricuspid regurgitation within a 6-month postoperative follow-up. Our study indicates that repairing the tricuspid valve while addressing the aortic and mitral valves does not pose significant additional risk. The observed improvement of the degree of tricuspid regurgitation without tricuspid operation suggests the need to further define subpopulations of patients with multivalvular disease.
Tricuspid valve repair while addressing the aortic and mitral valve was not associated with increased risk indicating the safety of performing triple valve surgery. There is a fraction of patients within the DVS group who experienced TR improvement. TR, tricuspid regurgitation; DVS, double valve surgery. [Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32060011</pmid><doi>10.1053/j.semtcvs.2020.02.010</doi><tpages>8</tpages></addata></record> |
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| ispartof | Seminars in thoracic and cardiovascular surgery, 2020-01, Vol.32 (4), p.665-672 |
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| subjects | Aged Aged, 80 and over Aortic Valve - diagnostic imaging Aortic Valve - physiopathology Aortic Valve - surgery Cardiac Surgical Procedures - adverse effects Female Heart Valve Diseases - diagnostic imaging Heart Valve Diseases - physiopathology Heart Valve Diseases - surgery Hemodynamics Humans Male Middle Aged Mitral Valve - diagnostic imaging Mitral Valve - physiopathology Mitral Valve - surgery Multiple valve surgery Postoperative Complications - etiology Recovery of Function Retrospective Studies Risk Factors Treatment Outcome Tricuspid valve Tricuspid Valve - diagnostic imaging Tricuspid Valve - physiopathology Tricuspid Valve - surgery Triple valve surgery |
| title | Combined Valve Operations in the Aortic and Mitral Positions With or Without Added Tricuspid Valve Repair |
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