Late Outcome of Tricuspid Annuloplasty Using a Flexible Band/Ring for Functional Tricuspid Regurgitation
|
|
- Frederica Thornton
- 5 years ago
- Views:
Transcription
1 Circulation Journal Official Journal of the Japanese Circulation Society ORIGINAL ARTICLE Cardiovascular Surgery Late Outcome of Tricuspid Annuloplasty Using a Flexible Band/Ring for Functional Tricuspid Regurgitation Naoto Fukunaga, MD; Yukikatsu Okada, MD, PhD; Yasunobu Konishi, MD; Takashi Murashita, MD; Tadaaki Koyama, MD, PhD Background: We assessed late outcome after tricuspid annuloplasty (TAP) using a flexible band or ring for functional tricuspid regurgitation (FTR). Methods and Results: We reviewed 220 consecutive patients (mean age, 65.4±11.4 years) who underwent TAP for FTR during mitral valve surgery between January 2000 and December Indications for TAP included the following: (1) TR grade greater than mild; (2) history of right heart failure; (3) atrial fibrillation; and (4) systolic pulmonary artery pressure (SPAP) 50 mmhg. The mean follow-up period was 4.4±2.6 years. Overall hospital mortality was 5.5% (12/220). The 5- and 10-year survival rates were 90.2±2.1% and 82.4±5.6%, respectively. Freedom from recurrent TR at 8 years was 78.0±6.6%. Twenty patients had a greater than mild TR grade at final follow-up. Elevated SPAP was a predictor of recurrent TR (hazard ratio, 1.091; P=0.0003), which was associated with advanced age, atrial fibrillation, rheumatic etiology and preoperative TR grade. There was a significant difference in freedom from valve-related events between residual TR greater than mild and less than moderate (log-rank test, P=0.0464). Factors affecting residual TR were preoperative TR grade (OR, 7.368; P=0.0267) and mitral valve replacement (OR, 4.369; P=0.0402). Conclusions: Late outcome of TAP in the present series was acceptable. Late outcome can be improved by performing TAP before deterioration of TR. (Circ J 2015; 79: ) Key Words: Functional tricuspid regurgitation; Tricuspid annuloplasty Functional tricuspid regurgitation (FTR) mainly occurs because of tricuspid annular dilation and right ventricular enlargement and/or right ventricular dysfunction in mitral valve diseases. 1,2 FTR causes further right ventricular dilatation, dysfunction, or more annular dilatation, subsequently worsening FTR. 1 Increasing severity of FTR is associated with poor survival in healthy men irrespective of left ventricular function or pulmonary hypertension. 3 Despite improved understanding of FTR and its surgical management, reports of late survival associated with FTR are limited. Guenther et al showed that 10-year survival after tricuspid annuloplasty (TAP) was 46%, 4 and Pfannmuller et al showed that 5-year survival was approximately 60%. 5 Persistent FTR after mitral prosthetic replacement is reported to be a risk factor for postoperative congestive heart failure and late mortality. 6 In redo series of mitral valve surgery, persistent FTR had a negative effect on late survival. 7 FTR after TAP in redo valvular surgery also affected late outcome. 8 Evidence supports the superiority of TAP with an annulo- plasty ring over suture annuloplasty. 4,9 We have consistently performed TAP using a flexible ring or band for >10 years. This study assessed late survival and freedom from recurrent or progressive FTR following TAP for FTR. Additionally, the effect of residual TR on late outcome was investigated. Methods This retrospective study was approved by the institutional review board. We retrospectively reviewed the medical records of 220 patients (mean age, 65.4±11.4 years; range, years) who underwent TAP for FTR in the setting of mitral valve surgery at Kobe City Medical Center General Hospital between January 2000 and December Of 220 patients, 160 (72.7%) underwent mitral valve repair (MVP), and 60 (27.3%) underwent mitral valve replacement (MVR). Patient preoperative characteristics are listed in Table 1. With regard to mitral etiology, degenerative entities comprised 94% in patients who had MVP, and rheumatic disease accounted for 87% in those Received November 24, 2014; revised manuscript received January 19, 2015; accepted January 25, 2015; released online March 3, 2015 Time for primary review: 23 days Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan This study was presented orally at the Fifth Annual Joint Scientific Session of the Heart Valve Society of America and Society of Heart Valve Diseases, New York City, NY, USA, 8 10 May Mailing address: Naoto Fukunaga, MD, Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Minatojimaminamimachi, Chuo-ku, Kobe , Japan. naotowakimachi@hotmail.co.jp ISSN doi: /circj.CJ All rights are reserved to the Japanese Circulation Society. For permissions, please cj@j-circ.or.jp
2 1300 FUKUNAGA N et al. Table 1. Patient Characteristics (n=220) Variables MVP (n=160) MVR (n=60) P-value Age (years) 64.7± ± Hypertension 74 (46) 18 (30) Diabetes mellitus 24 (15) 15 (25) Hyperlipidemia 41 (26) 12 (20) COPD 5 (3) 3 (5) Congestive HF 4 (2) 1 (2) PAD 7 (4) 4 (7) Stroke 15 (9) 11 (18) Creatinine 1.5 mg/dl 13 (8) 9 (15) Hemodialysis 5 (3) 5 (8) Liver cirrhosis 4 (2) 1 (2) CAD 24 (15) 6 (10) Atrial fibrillation 94 (59) 53 (88) < NYHA III or IV 35 (22) 26 (43) Non-elective 7 (4) 2 (3) Infective endocarditis 8 (5) 0 (0) Etiology < Degenerative 151 (94) 8 (13) Rheumatic 9 (6) 52 (87) Data given as n (%) or mean ± SD. CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; HF, heart failure; MVP, mitral valve repair; MVR, mitral valve replacement; NYHA, New York Heart Association; PAD, peripheral artery disease. who had MVR. TR was graded using transthoracic echocardiography as 0 for no regurgitation, 1+ for mild regurgitation, 2+ for moderate regurgitation, 3+ for moderately severe regurgitation and 4+ for severe regurgitation. Late recurrent TR was defined as an increase in TR greater than 1 grade compared with the grade of FTR before discharge, and TR grade greater than mild at final follow-up. The mean follow-up period was 4.4±2.6 years (range, years). The rate of follow-up was 100% when present data were collected. The follow-up rate for transthoracic echocardiography was 87.9%. Indications for TAP for FTR Before September 2007, TAP was indicated for patients with FTR greater than mild or a physical history of right heart failure (eg, leg edema or jaundice). During follow-up after mitral valve surgery, atrial fibrillation and pulmonary hypertension were recognized as risk factors for the development of recurrent TR based on our previous experience. Therefore, as of September 2007, new surgical indications for TAP included one of the following conditions: (1) TR grade greater than mild; (2) history of right heart failure; (3) atrial fibrillation; and (4) systolic pulmonary artery pressure (SPAP) >50 mmhg. The number of patients before September 2007 was 67 (30.0%). Surgical Procedure After standard median sternotomy and bicaval/aortic cannulation, the superior and inferior venae cavas were taped together. After obtaining cardiac arrest, mattress sutures with 2-0 braided suture (RB1) were placed on the tricuspid annulus from the anterior part of the anterioseptal commissure to the center of the septal annulus. We have consistently used a flexible ring or band for TAP, because the tricuspid annulus changes shape and size during the cardiac cycle. 10 We believe that the atrioventricular annu- lus should still have physiological motion after repair. 11 Based on these experiences, a flexible ring or band is used. After 2007, only a flexible band was used for TAP. Fukuda et al showed that the normal value of tricuspid valve area in systole was 3.9±0.8 cm 2 /m When the average body surface area for Japanese subjects is calculated (men, 1.7 m 2 ; women, 1.5 m 2 ), the minimum calculated tricuspid valve area is 6.63 cm 2 in men and 5.85 cm 2 in women during systole. The size of the tricuspid annulus following TAP was targeted to normal systolic size in individual patients. A 27- or 29-mm prosthesis was used in 95% of the patients. Prosthetic size was determined preoperatively based on body surface area. Plication was carefully measured from the anteroposterior commissure to the posteroseptal commissure. Half of the band corresponded to the anterior annulus and the other half corresponded to the posterior annulus and part of the septal annulus. In this study, patients who required an additional tricuspid procedure were not included. Concomitant procedures, except for mitral valve surgery, included aortic valve replacement (n=32), maze procedure (n=30), coronary artery bypass grafting (n=19), closure of atrial septal defect (n=6), left atrial plication (n=3), and closure of ventricular septal defect (n=1). Mean duration of cardiopulmonary bypass and cardiac arrest were 194.9±61.4 min and 144.1±47.2 min, respectively. Statistical Analysis Statistical analysis was done using StatView version 5.0 (SAS Institute, Cary, NC, USA). Categorical variables are expressed as the number of patients (%) and were compared between groups using chi-squared test. Continuous variables are expressed as mean ± SD and were compared between groups using Student s unpaired t-test. The Kaplan-Meier method was used to calculate long-term survival and freedom from postoperative complications.
3 TAP Using a Flexible Band/Ring 1301 Table 2. TTE Data Variables Preoperative TTE Before discharge Postoperative TTE P-value Follow-up TTE P-value LVEDD (mm) 52.3± ±7.6 < ±6.8 < LVESD (mm) 33.7± ± ±7.3 < LAD (mm) 52.2± ±9.1 < ±8.9 < LVEF (%) 62.3± ±11.3 < ±8.7 < SPAP (mmhg) 46.6± ±9.0 < ±14.1 < TR grade 1.9± ±0.6 < ±0.7 < TR moderate 56.3 (124) 7.7 (16) 13.9 (29) Data given as mean ± SD or n (%). LAD, left atrial diameter; LVEDD, left ventricular end-diastolic dimension; LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic dimension; SPAP, systolic pulmonary artery pressure; TR, tricuspid regurgitation; TTE, transthoracic echocardiography. Univariate analysis was performed with Fisher s exact probability test or Student s unpaired t-test. Variables that were not significant on univariate analysis, but had P<0.2 were included in multivariate logistic regression analysis to determine the independent predictors of hospital morbidity and mortality. Risk factors for long-term survival were evaluated using Cox multivariate regression analysis. Results A total of in 11 patients (18.3%) who had MVR and 32 (20%) who had MVP were older the 75 years. More patients had a history of atrial fibrillation in the MVR group than in the MVP group (P<0.0001). New York Heart Association (NYHA) functional class greater than III was more frequent in the MVR group compared with the MVP group (P=0.0015). Preoperative transthoracic echocardiographic data are given in Table 2. TR grade greater than mild was present in 124 patients (56.3%). Severe TR grade was observed in 55 patients (25.0%). Early Outcome Overall hospital mortality was 5.5% (12/220), and 30-day mortality was 2.7% (6/220). Cause of death was pneumonia (n=6), postoperative mediastinitis (n=3), gastrointestinal necrosis (n=2), low output syndrome (n=1) and hepatic failure (n=1). Postoperative comorbidities are listed in Table 3. Newly required pacemaker implantation was necessary in 9 patients (4.1%). Mediastinitis occurred in 6 patients (2.7%), and 2 of them died. Predischarge transthoracic echocardiographic data are given in Table 2. The left atrial diameter became smaller and SPAP was decreased with a mean pressure of 35.4 mmhg. The severity of TR was 0.7, and greater than mild TR was present in 16 survivors (7.7%). A total of 124 patients had TR greater than mild preoperatively, and 14 (3.2%) of them had residual TR greater than mild after TAP. Late Survival The 5- and 10-year survival rates were 90.2±2.1% and 82.4±5.6%, respectively (Figure 1). There were 10 late deaths, due to heart failure (n=4), pneumonia (n=3), rupture of the sinus of Valsalva (n=1), prosthetic valve endocarditis (n=1), and an unknown cause (n=1). Heart failure occurred in 4 patients within 3 years after discharge and their left ventricular ejection fraction was 40% at predischarge echocardiography. Table 3. Early Outcome Variables % (n) Hospital mortality 5.5 (12) 30-day mortality 2.7 (6) Morbidities Re-exploration for bleeding 5.9 (13) Stroke 2.7 (6) Cerebral hemorrhage 0.9 (2) Gastrointestinal bleeding 0.5 (1) Pneumonia 1.4 (3) Mediastinitis 2.7 (6) Tracheostomy 2.7 (6) Pacemaker implant 4.1 (9) Newly required dialysis 1.4 (3) Prosthetic valve endocarditis was present in a 62-year-old woman. Her initial surgery included TAP, MVP, and aortic valve replacement for active endocarditis. Recurrence of infection was strongly suspected, but she refused redo surgery. Recurrent TR and Analysis of Predictors Rate of freedom from recurrent TR at 5 and 8 years was 87.7±4.2% and 78.0±6.6%, respectively (Figure 2). Twenty patients had greater than mild TR at final follow-up. Of these 20 patients, 16 with a TR grade of moderate were asymptomatic. Among 4 patients with a severe TR grade, however, 2 developed edema that required an additional dose of diuretics and 2 complained of dyspnea on excursion. One patient needed readmission because of heart failure. The causes of severe FTR were tricuspid valve tethering in 1 patient, and tricuspid annular dilatation with persistent SPAP in 3 patients. Elevated SPAP was identified as a predictor of recurrent TR (hazard ratio, 1.091; 95% CI: ; P=0.0003). Furthermore, to identify the preoperative characteristics of recurrent TR, survivors were classified into 2 groups based on SPAP at final follow-up (Table 4). In the group with SPAP 50 mmhg, advanced age, higher frequency of atrial fibrillation, and rheumatic etiology were observed. With regard to echocardiographic data, there was a significantly greater number of patients with greater than mild TR in the elevated SPAP group. With regard to electrocardiogram at late follow-up in 187 patients (follow up rate, 89.9%), 68 patients (36.4%) had atrial
4 1302 FUKUNAGA N et al. Figure 1. Kaplan-Meier curve of late survival. Figure 2. Freedom from recurrent tricuspid regurgitation (TR). fibrillation, and 100 patients (53.5%), sinus rhythm. Of these 100 patients, 48 had atrial fibrillation preoperatively. Effect of Residual TR on Late Outcome The effect of residual TR that was less than moderate or greater than mild after TAP on late survival, and on valverelated events, was analyzed. There was no significant difference in late survival between residual TR that was less than moderate and greater than mild (log-rank P=0.4400; Figure 3A). There was a significant difference, however, in freedom from valve-related events between the 2 groups (log-rank P=0.0464; Figure 3B). Risk factors of residual TR greater than mild following TAP were preoperative TR grade (OR, 7.368; 95% CI: ; P=0.0267) and MVR (OR, 4.369; 95% CI: ; P=0.0402). These 2 factors were consistent with those for recurrent TR, as described earlier. Effect of Preoperative TR Grade on Survival As preoperative TR grade worsened, late survival was likely to be poorer (log-rank P=0.0622; Figure 4). The survival rate at 6 years was 93.6±2.5% for less than moderate vs. 91.7±3.7% for moderate TR, vs. 82.8±5.2% for severe TR. Discussion The 5- and 10-year survival rates following mitral valve procedures associated with TAP were 90.2±2.1% and 82.4±5.6%, respectively, in the present series. Because moderate to severe FTR has a negative effect on late survival after surgery, the main objective of TAP for FTR is to improve late survival
5 TAP Using a Flexible Band/Ring 1303 Table 4. Preoperative Patient Characteristics vs. Final SPAP Variables SPAP <50 mmhg SPAP 50 mmhg (n=160) (n=23) P-value Age (years) 64.1± ± Hypertension 69 (43) 10 (43) Diabetes mellitus 23 (14) 7 (30) Hyperlipidemia 40 (25) 5 (22) COPD 5 (3) 1 (4) Congestive HF 1 (1) 0 (0) PAD 7 (4) 2 (9) Stroke 18 (11) 4 (17) Creatinine 1.5 mg/dl 10 (6) 3 (13) Hemodialysis 4 (3) 1 (4) Liver cirrhosis 0 (0) 3 (13) CAD 18 (11) 3 (13) Atrial fibrillation 101 (63) 22 (96) NYHA III or IV 34 (21) 7 (30) Non-elective 3 (2) 0 (0) Infective endocarditis 5 (3) 0 (0) Etiology Degenerative 122 (76) 13 (57) Rheumatic 38 (24) 10 (43) Echocardiographic data LVEDD (mm) 52.8± ± LVESD (mm) 33.7± ± LAD (mm) 51.3± ± LVEF (%) 62.6± ± SPAP (mmhg) 45.7± ± TR grade 1.8± ± TR moderate 83 (52) 19 (83) Data given as n (%) or mean ± SD. Abbreviations as in Tables 1,2. without considerable residual FTR. We determined the effect of residual TR after TAP on late outcome. Residual TR greater than mild had a negative effect on freedom from valve-related events (Figure 3B), but there was no significant difference in survival. At 8 years, survival with residual TR greater than mild appeared to be poorer than that for residual TR less than moderate (Figure 3A). This finding suggests that no residual TR after TAP leads to improvement of late outcome. In this series, we focused on patients who underwent TAP and mitral procedures. Previously, we reported the importance of aggressive surgical intervention for FTR in the setting of MVP for degenerative mitral regurgitation. 12 Although mitral procedures, including repair or valve replacement, affect survival and recurrent FTR, these annuloplasty procedures were applied in this series. Patients who required TAP in this series were a high-risk group and had advanced NYHA functional class. Hospital and 30-day mortality rates were 5.5% and 2.7%, respectively. These rates were relatively higher than those in the annual report of the Japanese Association for Thoracic Surgery. 13 The report showed that hospital and 30-day mortality rates after TAP and MVP were 2.7% and 1.9%, respectively. 13 Although the reason for this discrepancy in mortality rate is not known, prolonged duration of cardiopulmonary bypass and cardiac arrest might contribute to these outcomes in addition to high-risk classification. Overall survival rate, however, was acceptable compared with other reports, taking into consideration mean patient age. 4,5 The incidence of recurrent FTR is generally higher in suture annuloplasty compared with ring annuloplasty. With regard to ring annuloplasty for FTR, there is still controversy regarding selection of size and the type of prosthetic ring. The tricuspid annulus in healthy subjects has a non-planar configuration and changes its size and shape dynamically during the cardiac cycle. 10 The ideal target size and shape in tricuspid ring annuloplasty is theoretically considered to be normal systolic size and shape unless there is right ventricular dysfunction. There were 2 reasons why a flexible ring or band was selected in TAP in this series: (1) early surgery and the maze procedure might restore physiological motion of the tricuspid annulus after ring annuloplasty; 10 and (2) a flexible band/ring has a low incidence of dehiscence after ring annuloplasty. 5 Selection of prosthetic band size has traditionally been determined by measuring the distance of the septal leaflet or the surface area of the anterior leaflet. Actually, neither size is reliable for selecting ring size. Therefore, in the present study, selection of ring size was determined by body surface area to obtain a normal systolic size in individual patients, and plication was carefully measured as described by Carpentier et al. Freedom from FTR greater than mild at 5 and 8 years was 87.7±4.2% and 78.0±6.6%, respectively. Twenty patients experienced recurrent TR greater than mild. The rate of recurrent TR at late follow-up was 9.6% (20/208). Of the 20 patients, 4 had severe recurrent TR. Gatti et al described outcomes of TAP using the Cosgrove-Edwards flexible ring with a mean follow-up of approximately 20 months. On final follow-up echocardiography, TR in survivors was controlled to within
6 1304 FUKUNAGA N et al. Figure 3. (A) Late survival and (B) freedom from valve-related events for residual tricuspid regurgitation (TR) greater than mild and less than moderate. Figure 4. Kaplan-Meier curve of survival based on preoperative tricuspid regurgitation (TR) grade. mild. 14 In another report, 10% of the survivors had moderate TR at final follow-up, 15 which was similar to the present rate of recurrent TR. We found that elevated SPAP at follow-up was a risk factor for recurrent TR. Elevated SPAP was associated with the following factors: advanced age, atrial fibrillation, rheumatic etiology in the mitral valve and severe preoperative TR. Of these 4 factors, rheumatic etiology and preoperative TR grade were
7 TAP Using a Flexible Band/Ring 1305 also associated with residual TR greater than mild after TAP. Although we cannot change mitral etiology, we can improve preoperative TR grade. Early intervention for TR can lead to prevention of residual TR greater than mild and recurrent TR, subsequently resulting in better late outcome. Song et al analyzed factors associated with development of late TR after left-sided heart valve surgery without tricuspid valve intervention. The overall rate of late TR was 7.7% and rheumatic etiology was one of the negative factors for late TR. 16 Similarly, we found that rheumatic etiology in the mitral valve was associated with recurrent TR. Patients with rheumatic valves tend to be operated on at an advanced stage of disease. 16 In the present study, patients who underwent MVR for mainly rheumatic etiology had a higher frequency of atrial fibrillation and had an advanced stage of NYHA. We consider that these associations cause development of atrial fibrillation or elevated SPAP, subsequently resulting in recurrent TR in the setting of rheumatic etiology. Optimal referral to surgery should be considered before irreversible cardiac changes occur. Yiu et al recommended tricuspid valve surgery before the development of symptoms because symptom-based surgery for TR has devastating outcomes. 17 Huang et al described the outcome in TAP for FTR compared with suture and ring annuloplasty. 18 They found that risk factors for recurrent TR included severity of preoperative TR, atrial fibrillation, and elevated SPAP, 18,19 similar to the present study. Another study showed that left ventricular dysfunction, the presence of a permanent pacemaker, and suture annuloplasty were risk factors for recurrent TR. 20 Atrial fibrillation has been reported to be strongly associated with recurrent TR. The utility of the maze procedure has been studied to treat atrial fibrillation, but there is controversy as to whether this is effective. In the present study, of 148 patients, 30 (20%) underwent the maze procedure. The grade of FTR in patients who have a chance to have cardiac rhythm restored by the maze procedure may be well controlled by combination of this with ring annuloplasty. Recurrent moderate to severe FTR develops in patients who are not good candidates for the maze procedure. With regard to elevated SPAP as a risk factor for recurrent TR, 18,19 there were 2 patients with late severe TR and persistent elevated SPAP postoperatively. The present study demonstrated that preoperative SPAP did not affect late recurrent TR. McCarthy et al described left ventricular dysfunction as a risk factor for recurrent TR. 20 In the present study, left ventricular function was normal in patients with recurrent TR and was not a risk factor. There are several tricuspid procedures including suture annuloplasty and ring annuloplasty. As we previously reported, tricuspid leaflet augmentation using glutaraldehyde-treated autologous pericardium is an alternative technique for recurrent severe FTR associated with tricuspid tethering. 21 Tricuspid valve replacement (TVR) is another alternative for managing severe FTR. We have carried out only a few TVR, including redo surgery in the past 10 years, because outcome in TVR is worse than in TAP. We have performed TAP as much as possible. A recent report noted 5- and 10-year survival rates after TVR with a bioprosthesis of 63.6±8.9% and 56.5±10.3%, respectively. 22 Freedom from reoperation at 10 years was 100%. 17 In specific cases, such as stenotic valve disease associated with rheumatic change, TVR may be indicated. 23 We found that rheumatic etiology was a factor for late recurrent TR. Therefore, TVR for patients with rheumatic diseased valves is appropriate. In the present study, 1 patient who underwent TAP with anterior leaflet augmentation had severe late recurrent TR because of leaflet tethering caused by right ventricular dysfunction. TVR should be considered as an alternative procedure to TAP because TAP alone cannot prevent massive residual TR. The present study, which was retrospective in nature, has 2 main important limitations. The first limitation is the large heterogeneous patient group, because the present study included all patients who underwent concomitant TAP for FTR in the setting of MVP or MVR. We introduced strict indications for TAP and performed TAP for 172 patients (78.2%) after These conditions might have affected late survival or freedom from recurrent TR. The second limitation is the lack of echocardiography data, such as right ventricular function, diameter and tricuspid valve tethering area or height, which are important variables for predicting the outcome of TAP. 17 This is because it was difficult to measure these parameters. The third limitation is that we do not have data supporting the flexibility of implanted bands after TAP. The idea of using a flexible band/ring was based on mitral annular analysis after implantation of a flexible band. 10 In the future, we will investigate tricuspid annular motion on imaging. Regardless of these limitations, we included a relatively large number of patients (n=220) who underwent TAP using a flexible band, and the patient follow-up rate was 100%. Additionally, an optimal follow-up rate of echocardiography was achieved (87.9%). Conclusions Late outcome of TAP using a flexible ring or band based on the current strategy is acceptable. Optimal timing for surgery, especially before TR progression, should be taken into account to prevent residual TR greater than moderate, and recurrent TR. Disclosures Conflict of Interest: The authors declare no conflict of interest. References 1. Shiran A, Sagie A. Tricuspid regurgitation in mitral valve disease: Incidence, prognostic implications, mechanism, and management. J Am Coll Cardiol 2009; 53: Rogers JH, Bolling SF. The tricuspid valve: Current perspective and evolving management of tricuspid regurgitation. Circulation 2009; 119: Nath J, Foster E, Heidenreich PA. Impact of tricuspid regurgitation on long-term survival. J Am Coll Cardiol 2004; 43: Guenther T, Mazzitelli D, Noebauer C, Hettich I, Tassani-Prell P, Voss B, et al. Tricuspid valve repair: Is ring annuloplasty superior? Eur J Cardiothorac Surg 2013; 43: Pfannmuller B, Doenst T, Eberhardt K, Seeburger J, Borger MA, Mohr FW. Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings. J Thorac Cardiovasc Surg 2012; 143: Ruel M, Rubens FD, Masters RG, Pipe AL, Bedard P, Mesana TG. Late incidence and predictors of persistent or recurrent heart failure in patients with mitral prosthetic valves. J Thorac Cardiovasc Surg 2004; 128: Fukunaga N, Okada Y, Konishi Y, Murashita T, Kanemitsu H, Koyama T. Impact of tricuspid regurgitation after redo valvular surgery on survival in patients with previous mitral valve replacement. J Thorac Cardiovasc Surg 2014; 148: Fukunaga N, Okada Y, Konishi Y, Murashita T, Koyama T. Persistent tricuspid regurgitation after tricuspid annuloplasty during redo valvular surgery affects late survival and valve-related events. Circ J 2014; 78: Khorsandi M, Banerjee A, Singh H, Srivastava AR. Is a tricuspid annuloplasty ring significantly better than a De Vega s annuloplasty stitch when repairing severe tricuspid regurgitation? Interact Cardiovasc Thorac Surg 2012; 15:
8 1306 FUKUNAGA N et al. 10. Fukuda S, Saracino G, Matsumura Y, Daimon M, Tran H, Greenberg NL, et al. Three-dimensional geometry of the tricuspid annulus in healthy subjects and in patients with functional tricuspid regurgitation: A real-time, 3-dimensional echocardiographic study. Circulation 2006; 114(Suppl): I492 I Okada Y, Nasu M, Kawai J, Kanzaki Y. Flexibility of the mitral annulus with the Duran ring at six years post-implantation. J Heart Valve Dis 2002; 11: Murashita T, Okada Y, Kanemitsu H, Fukunaga N, Konishi Y, Nakamura K, et al. Fate of functional tricuspid regurgitation after mitral valve repair for degenerative mitral regurgitation. Circ J 2013; 77: Masuda M, Kuwano H, Okumura M, Amano J, Arai H, Endo S, et al. Thoracic and cardiovascular surgery in Japan during 2012: Annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg 2014; 62: Gatti G, Maffei G, Lusa AM, Pugliese P. Tricuspid valve repair with the Cosgrove-Edwards annuloplasty system: Early clinical and echocardiographic results. Ann Thorac Surg 2001; 72: Gatti G, Marciano F, Antonini-Canterin F, Pinomonti B, Benussi B, Pappalardo A, et al. Tricuspid valve annuloplasty with a flexible prosthetic band. Interact Cardiovasc Thorac Surg 2007; 6: Song H, Kim MJ, Chung CH, Choo SJ, Song MG, Song JM, et al. Factors associated with development of late significant tricuspid regurgitation after successful left-sided valve surgery. Heart 2009; 95: Yiu KH, Wong A, Pu L, Chiang MF, Sit KY, Chan D, et al. Prognostic value of preoperative right ventricular geometry and tricuspid valve tethering area in patients undergoing tricuspid annuloplasty. Circulation 2014; 129: Huang X, Gu C, Men X, Zhang J, You B, Zhang H, et al. Repair of functional tricuspid regurgitation: Comparison between suture annuloplasty and rings annuloplasty. Ann Thorac Surg 2014; 97: Rajbanshi BG, Suri RM, Nkomo TV, Dearani JA, Daly RC, Burkhart HM, et al. Influence of mitral valve repair versus replacement on the development of late functional tricuspid regurgitation. J Thorac Cardiovasc Surg 2014; 148: McCarthy PM, Bhudia SK, Rajeswaran J, Hoercher KJ, Lytle BW, Cosgrove DM, et al. Tricuspid valve repair: Durability and risk factors for failure. J Thorac Cardiovasc Surg 2004; 127: Murashita T, Okada Y, Nasu M, Fujiwara H, Koyama T, Shomura Y, et al. Tricuspid leaflet augmentation with an autologous pericardial patch for recurrent severe tricuspid regurgitation that occurred after suture annuloplasty. Surg Today 2013; 43: Morimoto N, Matsushima S, Aoki M, Henmi S, Nishioka N, Murakami H, et al. Long-term results of bioprosthetic tricuspid valve replacement: An analysis of 25 years of experience. Gen Thorac Cardiovasc Surg 2013; 61: Park CK, Park PW, Sung K, Lee YT, Kim WS, Jun TG. Early and midterm outcomes for tricuspid valve surgery after left-sided valve surgery. Ann Thorac Surg 2009; 88:
Persistent Tricuspid Regurgitation After Tricuspid Annuloplasty During Redo Valve Surgery Affects Late Survival and Valve-Related Events
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp Advance Publication by-j-stage Persistent Tricuspid Regurgitation After Tricuspid Annuloplasty During Redo
More informationAnn Thorac Cardiovasc Surg 2015; 21: Online April 18, 2014 doi: /atcs.oa Original Article
Ann Thorac Cardiovasc Surg 2015; 21: 53 58 Online April 18, 2014 doi: 10.5761/atcs.oa.13-00364 Original Article The Impact of Preoperative and Postoperative Pulmonary Hypertension on Long-Term Surgical
More informationThe operative mortality rate after redo valvular operations
Clinical Outcomes of Redo Valvular Operations: A 20-Year Experience Naoto Fukunaga, MD, Yukikatsu Okada, MD, Yasunobu Konishi, MD, Takashi Murashita, MD, Mitsuru Yuzaki, MD, Yu Shomura, MD, Hiroshi Fujiwara,
More informationDoes Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement?
Original Article Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement? Hiroaki Sakamoto, MD, PhD, and Yasunori Watanabe, MD, PhD Background: Recently, some articles
More informationDe Vega Annuloplasty for Functional Tricupsid Regurgitation: Concept of Tricuspid Valve Orifice Index to Optimize Tricuspid Valve Annular Reduction
ORIGINAL ARTICLE Cardiovascular Disorders http://dx.doi.org/10.3346/jkms.2013.28.12.1756 J Korean Med Sci 2013; 28: 1756-1761 De Vega Annuloplasty for Functional Tricupsid Regurgitation: Concept of Tricuspid
More informationClinical material and methods. Fukui Cardiovascular Center, Fukui, Japan
Mitral Valve Regurgitation after Atrial Septal Defect Repair in Adults Shohei Yoshida, Satoshi Numata, Yasushi Tsutsumi, Osamu Monta, Sachiko Yamazaki, Hiroyuki Seo, Takaaki Samura, Hirokazu Ohashi Fukui
More informationManagement of Tricuspid Regurgitation
Management of Tricuspid Regurgitation Antonis A. Pitsis, FETCS, FESC Thessaloniki Heart Institute, St. Luke s Hospital, Thessaloniki, GREECE HEART FAILURE 2012 BELGRADE SERBIA Does Tricuspid Regurgitation
More informationRisk Analysis of the Long-Term Outcomes of the Surgical Closure of Secundum Atrial Septal Defects
Korean J Thorac Cardiovasc Surg 2017;50:78-85 ISSN: 2233-601X (Print) ISSN: 2093-6516 (Online) CLINICAL RESEARCH https://doi.org/10.5090/kjtcs.2017.50.2.78 Risk Analysis of the Long-Term Outcomes of the
More informationLate secondary TR after left sided heart disease correction: is it predictibale and preventable
Late secondary TR after left sided heart disease correction: is it predictibale and preventable Gilles D. Dreyfus Professor of Cardiothoracic surgery Nath J, et al. JACC 2004 PREDICT Incidence of secondary
More informationHaiping Wang 1,2, Xiancheng Liu 2, Xin Wang 2, Zhenqian Lv 2, Xiaojun Liu 2, Ping Xu 1. Introduction
Original Article Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease Haiping
More informationHani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz
Hani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia Decision process for
More informationHani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia.
Hani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia. Decision process for Management of any valve Timing Feasibility
More informationWhich Type of Secondary Tricuspid Regurgitation Accompanying Mitral Valve Disease Should Be Surgically Treated?
Ann Thorac Cardiovasc Surg 2013; 19: 428 434 Online January 31, 2013 doi: 10.5761/atcs.oa.12.01929 Original Article Which Type of Secondary Tricuspid Regurgitation Accompanying Mitral Valve Disease Should
More informationMechanism of and Risk Factors for Reoperation After Mitral Valve Repair for Degenerative Mitral Regurgitation
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp Advance Publication by-j-stage Mechanism of and Risk Factors for Reoperation After Mitral Valve Repair for
More informationExpanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated?
Expanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated? RM Suri, V Sharma, JA Dearani, HM Burkhart, RC Daly, LD Joyce, HV Schaff Division of Cardiovascular Surgery, Mayo Clinic, Rochester,
More informationQuality Outcomes Mitral Valve Repair
Quality Outcomes Mitral Valve Repair Moving Beyond Reoperation Rakesh M. Suri, D.Phil. Professor of Surgery 2015 MFMER 3431548-1 Disclosure Mayo Clinic Division of Cardiovascular Surgery Research funding
More informationOutcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease
Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease TIRONE E. DAVID, MD ; SEMIN THORAC CARDIOVASC SURG 19:116-120c 2007 ELSEVIER INC. PRESENTED BY INTERN 許士盟 Mitral valve
More informationPresenter Disclosure. Patrick O. Myers, M.D. No Relationships to Disclose
Presenter Disclosure Patrick O. Myers, M.D. No Relationships to Disclose Aortic Valve Repair by Cusp Extension for Rheumatic Aortic Insufficiency in Children Long term Results and Impact of Extension Material
More informationThe Tricuspid Valve: The Not So Forgotten Valve. Manuel J Antunes Cardiothoracic Surgery Coimbra, Portugal
The Tricuspid Valve: The Not So Forgotten Valve Manuel J Antunes Cardiothoracic Surgery Coimbra, Portugal No Conflicts of Interest to declare with regards to this subject 2 INCIDENCE OF TRICUSPID REGURGITATION
More informationA Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision
A Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision Prof. Pino Fundarò, MD Niguarda Hospital Milan, Italy Introduction
More information16 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 6900
CLINICAL COMMUNIQUé 6 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 69 The Carpentier-Edwards PERIMOUNT Mitral Pericardial Valve, Model 69, was introduced into clinical
More informationLong-term results (22 years) of the Ross Operation a single institutional experience
Long-term results (22 years) of the Ross Operation a single institutional experience Authors: Costa FDA, Schnorr GM, Veloso M,Calixto A, Colatusso D, Balbi EM, Torres R, Ferreira ADA, Colatusso C Department
More informationPay Attention to Valvular Disease in the Presence of Atopic Dermatitis
1862 FUKUNAGA N et al. Circulation Journal ORIGINAL ARTICLE Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp Valvular Heart Disease Pay Attention to Valvular Disease in the
More informationDisclosures. ESC Munich 2012 Bernard Iung, MD Consultancy: Abbott Boehringer Ingelheim Bayer Servier Valtech
Disclosures ESC Munich 2012 Bernard Iung, MD Consultancy: Abbott Boehringer Ingelheim Bayer Servier Valtech Speaker s fee Edwards Lifesciences Sanofi-Aventis Decision Making in Patients with Multivalvular
More informationChanges in Right Ventricular Volume and Function After Tricuspid Valve Surgery
1142 CHOI JW et al. Circulation Journal ORIGINAL ARTICLE Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp Cardiovascular Surgery Changes in Right Ventricular Volume and Function
More informationKinsing Ko, Thom de Kroon, Najim Kaoui, Bart van Putte, Nabil Saouti. St. Antonius Hospital, Nieuwegein, The Netherlands
Minimal Invasive Mitral Valve Surgery After Previous Sternotomy Without Aortic Clamping: Short- and Long Term Results of a Single Surgeon Single Institution Kinsing Ko, Thom de Kroon, Najim Kaoui, Bart
More informationCLINICAL COMMUNIQUE 16 YEAR RESULTS
CLINICAL COMMUNIQUE 6 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 6900 Introduction The Carpentier-Edwards PERIMOUNT Mitral Pericardial Valve, Model 6900, was introduced
More informationIsolated tricuspid valve surgery in patients with previous cardiac surgery
Isolated tricuspid valve surgery in patients with previous cardiac surgery Bettina Pfannm uller, MD, Monica Moz, MD, Martin Misfeld, MD, PhD, Michael A. Borger, MD, PhD, Anne-Kathrin Funkat, PhD, Jens
More informationTricuspid Annuloplasty Using the MC 3 Ring for Functional Tricuspid Regurgitation
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp ORIGINAL ARTICLE Cardiovascular Surgery Tricuspid Annuloplasty Using the MC 3 Ring for Functional Tricuspid
More informationFlexible band versus rigid ring annuloplasty for tricuspid regurgitation: a systematic review and meta-analysis
Systematic Review Flexible band versus rigid ring annuloplasty for tricuspid regurgitation: a systematic review and meta-analysis Nelson Wang, Steven Phan, David H. Tian 2,3, Tristan D. Yan 2, Kevin Phan,2
More informationSurgical repair of massive dilatation of the right atrium with tricuspid regurgitation
Okada et al. Journal of Cardiothoracic Surgery (2018) 13:83 https://doi.org/10.1186/s13019-018-0769-7 CASE REPORT Open Access Surgical repair of massive dilatation of the right atrium with tricuspid regurgitation
More informationEffect of Valve Suture Technique on Incidence of Paraprosthetic Regurgitation and 10-Year Survival
Effect of Valve Suture Technique on Incidence of Paraprosthetic Regurgitation and 10-Year Survival Sukumaran K. Nair, FRCS (C Th), Gauraang Bhatnagar, MBBS, Oswaldo Valencia, MD, and Venkatachalam Chandrasekaran,
More informationMitral Valve Disease, When to Intervene
Mitral Valve Disease, When to Intervene Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Current ACC/AHA guideline Stages
More informationRepair or Replacement
Surgical intervention post MitraClip Device: Repair or Replacement Saudi Heart Association, February 21-24 Rüdiger Lange, MD, PhD Nicolo Piazza, MD, FRCPC, FESC German Heart Center, Munich, Germany Division
More informationProf. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM
The Patient with Aortic Stenosis and Mitral Regurgitation Prof. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM Aortic Stenosis + Mitral Regurgitation?
More informationAlthough mitral valve replacement (MVR) is no longer the surgical
Surgery for Acquired Cardiovascular Disease Ruel et al Late incidence and predictors of persistent or recurrent heart failure in patients with mitral prosthetic valves Marc Ruel, MD, MPH a,b Fraser D.
More informationResults of Mitral Valve Replacement, with Special Reference to the Functional Tricuspid Insufficiency
Results of Mitral Valve Replacement, with Special Reference to the Functional Tricuspid Insufficiency Ken-ichi ASANO, M.D., Masahiko WASHIO, M.D., and Shoji EGUCHI, M.D. SUMMARY (1) Surgical results of
More informationConcomitant Tricuspid Valve Repair :
Concomitant Tricuspid Valve Repair : When to perform while awaiting data?! Steven F Bolling, MD Professor of Cardiac Surgery University of Michigan Is FTR important? Decreased CO Fatigue, decreased exercise
More informationClinical Outcome of Tricuspid Regurgitation. David Messika-Zeitoun
Clinical Outcome of Tricuspid Regurgitation David Messika-Zeitoun I have financial relationships to disclose Consultant for: Edwards, Symetis and Valtech Tricuspid Regurgitation is a Common Finding Tricuspid
More informationChronic Primary Mitral Regurgitation
Chronic Primary Mitral Regurgitation The Case For Early Surgical Intervention William K. Freeman, MD, FACC, FASE DISCLOSURES Relevant Financial Relationship(s) None Off Label Usage None Watchful Waiting......
More informationΧειρουργική Αντιμετώπιση της Ανεπάρκειας της Μιτροειδούς Βαλβίδας
Χειρουργική Αντιμετώπιση της Ανεπάρκειας της Μιτροειδούς Βαλβίδας Dr Χρήστος ΑΛΕΞΙΟΥ MD, PhD, FRCS(Glasgow), FRCS(CTh), CCST(UK) Consultant Cardiothoracic Surgeon Normal Mitral Valve Function Mitral Regurgitation
More informationMechanical Tricuspid Valve Replacement Is Not Superior in Patients Younger Than 65 Years Who Need Long-Term Anticoagulation
Mechanical Tricuspid Valve Replacement Is Not Superior in Patients Younger Than 65 Years Who Need Long-Term Anticoagulation Ho Young Hwang, MD, PhD, Kyung-Hwan Kim, MD, PhD, Ki-Bong Kim, MD, PhD, and Hyuk
More informationProposal of a Novel Index for Selection of Optimal Annuloplasty Ring Size for Tricuspid Annuloplication
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp ORIGINAL ARTICLE Cardiovascular Surgery Proposal of a Novel Index for Selection of Optimal Annuloplasty
More informationLong term outcomes of posterior leaflet folding valvuloplasty for mitral valve regurgitation
Featured Article Long term outcomes of posterior leaflet folding valvuloplasty for mitral valve regurgitation Igor Gosev 1, Maroun Yammine 1, Marzia Leacche 1, Siobhan McGurk 1, Vladimir Ivkovic 1, Michael
More informationPercutaneous Mitral Valve Repair: What Can We Treat and What Should We Treat
Percutaneous Mitral Valve Repair: What Can We Treat and What Should We Treat Innovative Procedures, Devices & State of the Art Care for Arrhythmias, Heart Failure & Structural Heart Disease October 8-10,
More informationDevelopment of tricuspid regurgitation late after left-sided valve surgery: A single-center experience with long-term echocardiographic examinations
Imaging and Diagnostic Testing Development of tricuspid regurgitation late after left-sided valve surgery: A single-center experience with long-term echocardiographic examinations Jae-Jin Kwak, MD, a Yong-Jin
More informationConcomitant tricuspid valve repair in patients with minimally invasive mitral valve surgery
Featured Article Concomitant tricuspid valve repair in patients with minimally invasive mitral valve surgery Bettina Pfannmüller, Piroze Davierwala, Gregor Hirnle, Michael A. Borger, Martin Misfeld, Jens
More informationSurgical treatment of tricuspid regurgitation after mitral valve surgery: a retrospective study in China
RESEARCH ARTICLE Open Access Surgical treatment of tricuspid regurgitation after mitral valve surgery: a retrospective study in China Zong-Xiao Li 1, Zhi-Peng Guo 1, Xiao-Cheng Liu 1, Xiang-Rong Kong 1,2,
More informationBicuspid aortic root spared during ascending aorta surgery: an update of long-term results
Short Communication Bicuspid aortic root spared during ascending aorta surgery: an update of long-term results Marco Russo, Guglielmo Saitto, Paolo Nardi, Fabio Bertoldo, Carlo Bassano, Antonio Scafuri,
More informationIndication, Timing, Assessment and Update on TAVI
Indication, Timing, Assessment and Update on TAVI Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Starr- Edwards Mechanical
More informationMitral Gradients and Frequency of Recurrence of Mitral Regurgitation After Ring Annuloplasty for Ischemic Mitral Regurgitation
Mitral Gradients and Frequency of Recurrence of Mitral Regurgitation After Ring Annuloplasty for Ischemic Mitral Regurgitation Matthew L. Williams, MD, Mani A. Daneshmand, MD, James G. Jollis, MD, John
More informationOutcomes of Surgical Aortic Valve Replacement in Moderate Risk Patients: Implications for Determination of Equipoise in the Transcatheter Era
Outcomes of Surgical Aortic Valve Replacement in Moderate Risk Patients: Implications for Determination of Equipoise in the Transcatheter Era Sebastian A. Iturra, Rakesh M. Suri, Kevin L. Greason, John
More informationSurgery For Ebstein Anomaly
Surgery For Ebstein Anomaly Christian Pizarro, MD Chief, Pediatric Cardiothoracic Surgery Director, Nemours Cardiac Center Alfred I. dupont Hospital for Children Professor of Surgery and Pediatrics Sidney
More information3D Echo for Evaluation of Tricuspid Regurgitation Jong-Min Song, MD, PhD
3D Echo for Evaluation of Tricuspid Regurgitation Jong-Min Song, MD, PhD Asan Medical Center University of Ulsan College of Medicine Seoul, Korea Causes of TR Primary causes (25%) Rheumatic Myxomatous
More informationExperience with 500 Stentless Aortic Valve Replacements
Experience with 500 Stentless Aortic Valve Replacements Dimitrios C. Iliopoulos, MD Cardiac Surgeon Ass. Professor of Surgery University of Athens, School of Medicine I declare no conflict of interest
More informationAnnular Stabilization Techniques in the Context of Aortic Valve Repair
Annular Stabilization Techniques in the Context of Aortic Valve Repair Prashanth Vallabhajosyula, MD MS University of Pennsylvania, Philadelphia, Pennsylvania 2 nd North American Aortic Valve Repair Symposium
More informationInfluence of Atrial Fibrillation on Outcome Following Mitral Valve Repair
Influence of Atrial Fibrillation on Outcome Following Mitral Valve Repair Eric Lim, MBChB, MRCS; Clifford W. Barlow, DPhil, FRCS; A. Reza Hosseinpour, FRCS; Christopher Wisbey, BA; Kate Wilson, RN, BSc;
More informationWhat is the Role of Surgical Repair in 2012
What is the Role of Surgical Repair in 2012 The Long-Term Results of Surgery Raphael Rosenhek Department of Cardiology Medical University of Vienna European Society of Cardiology 2012 Munich, August 27th
More informationOriginal Article Effects of mitral valve replacement concomitant with tricuspid annuloplasty on mild tricuspid valve insufficiency
Int J Clin Exp Med 2016;9(11):22062-22068 www.ijcem.com /ISSN:1940-5901/IJCEM0038891 Original Article Effects of mitral valve replacement concomitant with tricuspid annuloplasty on mild tricuspid valve
More informationReoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment
Reoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment W.R.E. Jamieson, MD; L.H. Burr, MD; R.T. Miyagishima, MD; M.T. Janusz, MD; G.J. Fradet, MD; S.V. Lichtenstein, MD; H. Ling, MD Background
More informationPrimary Mitral Valve Disease: Natural History & Triggers for Intervention ACC Latin American Conference 2017
Disclosures: GE stock, Primary Mitral Valve Disease: Natural History & Triggers for Intervention ACC Latin American Conference 2017 Athena Poppas, MD FACC Past ACC Scientific Sessions Chair, ACC Board
More informationDurability and Outcome of Aortic Valve Replacement With Mitral Valve Repair Versus Double Valve Replacement
Durability and Outcome of Aortic Valve Replacement With Mitral Valve Repair Versus Double Valve Replacement Masaki Hamamoto, MD, Ko Bando, MD, Junjiro Kobayashi, MD, Toshihiko Satoh, MD, MPH, Yoshikado
More informationReally Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients?
Really Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients? David H. Adams, MD Cardiac Surgeon-in-Chief Mount Sinai Health System Marie Josée and Henry R. Kravis Professor and
More informationSurgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea
Surgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea Contents Decision making in surgical AVR in old age Clinical results of AVR with tissue valve Impact of 19mm
More informationRecurrent mitral regurgitation after repair: Should the mitral valve be re-repaired?
Surgery for Acquired Cardiovascular Disease Recurrent mitral regurgitation after repair: Should the mitral valve be re-repaired? Rakesh M. Suri, MD, DPhil, Hartzell V. Schaff, MD, Joseph A. Dearani, MD,
More informationJournal of the American College of Cardiology Vol. 42, No. 3, by the American College of Cardiology Foundation ISSN /03/$30.
Journal of the American College of Cardiology Vol. 42, No. 3, 2003 2003 by the American College of Cardiology Foundation ISSN 0735-1097/03/$30.00 Published by Elsevier Inc. doi:10.1016/s0735-1097(03)00649-1
More informationCatheter-based mitral valve repair MitraClip System
Percutaneous Mitral Valve Repair: Results of the EVEREST II Trial William A. Gray MD Director of Endovascular Services Associate Professor of Clinical Medicine Columbia University Medical Center The Cardiovascular
More informationReconstruction of the intervalvular fibrous body during aortic and
Aortic and mitral valve replacement with reconstruction of the intervalvular fibrous body: An analysis of clinical outcomes Nilto C. De Oliveira, MD Tirone E. David, MD Susan Armstrong, MSc Joan Ivanov,
More informationPredicting functional mitral stenosis after restrictive annuloplasty for ischemic mitral regurgitation
Powered by TCPDF (www.tcpdf.org) This is a provisional PDF only. Copyedited and fully formatted version will be made available soon. ONLINE FIRST ISSN: 1897-5593 e-issn: 1898-018X Predicting functional
More informationCarpentier-Edwards Pericardial Valve in the Aortic Position: 25-Years Experience
SURGERY: The Annals of Thoracic Surgery CME Program is located online at http://www.annalsthoracicsurgery.org/cme/ home. To take the CME activity related to this article, you must have either an STS member
More informationThree Surgical Cases of Isolated Tricuspid Valve Infective Endocarditis
Case Report Three Surgical Cases of Isolated Tricuspid Valve Infective Endocarditis Hiroyuki Morokuma, MD, Naoki Minato, MD, PhD, Keiji Kamohara, MD, PhD, and Noritoshi Minematsu, MD Tricuspid valve infective
More informationSUPPLEMENTAL MATERIAL
SUPPLEMENTAL MATERIAL Table S1: Number and percentage of patients by age category Distribution of age Age
More informationPercutaneous mitral valve repair: current techniques and results
Percutaneous mitral valve repair: current techniques and results Ted Feldman, M.D., FSCAI, FACC Angioplasty Summit April 25-27 th th 2007 Seoul, Korea Ted Feldman MD, FACC, FSCAI Disclosure Information
More informationMohammad Sharif Popal, Jin-Tao Fu, Qiu-Ming Hu, Tian-Ge Luo, Shuai Zheng, Xu Meng
Original Article Intraoperative method based on tricuspid annular circumference in patients with mild or no tricuspid regurgitation during left-sided cardiac valve surgery for the prophylactic tricuspid
More informationPercutaneous technologies to correct TR : Myth or Reality? Steven F. Bolling, M.D. Professor of Cardiac Surgery University of Michigan
Percutaneous technologies to correct TR : Myth or Reality? Steven F. Bolling, M.D. Professor of Cardiac Surgery University of Michigan Disclosures Ownership Interest: Millipede and Pipeline TR is BAD Decreased
More informationSurgical Treatment for Atrioventricular Septal Defect. Masakazu Nakao Consultant, Paediatric Cardiothoracic Surgery
Surgical Treatment for Atrioventricular Septal Defect Masakazu Nakao Consultant, Paediatric Cardiothoracic Surgery 1 History Rastelli classification (Rastelli) Pulmonary artery banding (Muller & Dammann)
More informationClinical material and methods. Copyright by ICR Publishers 2007
16847_JHVD_Biancari_3197_(116-121)_r1:Layout 1 21/3/07 17:07 Page 116 Predicting Immediate and Late Outcome after Surgery for Mitral Valve Regurgitation with EuroSCORE Jouni Heikkinen, Fausto Biancari,
More informationSurgical AF Ablation : Lesion Sets and Energy Sources. What are the data? Steven F Bolling, MD Cardiac Surgery University of Michigan
Surgical AF Ablation : Lesion Sets and Energy Sources What are the data? Steven F Bolling, MD Cardiac Surgery University of Michigan Disclosures Consultant/Advisory Board: Abbott, Edwards Lifesciences
More informationMitral Valve Repair Versus Replacement in Simultaneous Mitral and Aortic Valve Surgery for Rheumatic Disease
Mitral Valve Repair Versus Replacement in Simultaneous Mitral and Aortic Valve Surgery for Rheumatic Disease Kenji Kuwaki, MD, PhD, Nobuyoshi Kawaharada, MD, PhD, Kiyofumi Morishita, MD, PhD, Tetsuya Koyanagi,
More informationImaging to select patients for Transcatheter TV
Imaging to select patients for Transcatheter TV Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands San Diego, february 2018 Research grants: Medtronic, Biotronik, Boston Scientific,
More informationSteven F Bolling Professor of Cardiac Surgery University of Michigan
Optimal Treatment of Functional MR Steven F Bolling Professor of Cardiac Surgery University of Michigan Functional MR Functional MR in Ischemia Badhwar, Bolling, chapter in: Advances in Heart Failure,
More informationIschemic mitral valve reconstruction and replacement: Comparison of long-term survival and complications
Surgery for Acquired Cardiovascular Disease Ischemic mitral valve reconstruction and replacement: Comparison of long-term survival and complications Eugene A. Grossi, MD Judith D. Goldberg, ScD Angelo
More informationOutline 9/17/2016. Advances in Percutaneous Mitral Valve Repair and Replacement. Scope of the Problem and Guidelines
Advances in Percutaneous Mitral Valve Repair and Replacement Scott M Lilly MD PhD, Interventional Cardiology The Ohio State University Contemporary Multidisciplinary Cardiovascular Conference Orlando,
More informationPreoperative Parameters Predicting the Postoperative Course of Endoventricular Circular Patch Plasty
Original Article Preoperative Parameters Predicting the Postoperative Course of Endoventricular Circular Patch Plasty Keiichiro Kondo, MD, Yoshihide Sawada, MD, and Shinjiro Sasaki, MD, PhD It is necessary
More informationCover Page. The handle holds various files of this Leiden University dissertation.
Cover Page The handle http://hdl.handle.net/1887/20135 holds various files of this Leiden University dissertation. Author: Braun, Jerry Title: Surgical treatment of functional mitral regurgitation Issue
More informationORIGINAL PAPER. The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan
Nagoya J. Med. Sci. 78. 369 ~ 376, 2016 doi:10.18999/nagjms.78.4.369 ORIGINAL PAPER The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan
More informationAtrioventricular valve repair: The limits of operability
Atrioventricular valve repair: The limits of operability Francis Fynn-Thompson, MD Co-Director, Center for Airway Disorders Surgical Director, Pediatric Mechanical Support Program Surgical Director, Heart
More informationDegenerative Mitral Regurgitation: Etiology and Natural History of Disease and Triggers for Intervention
Degenerative Mitral Regurgitation: Etiology and Natural History of Disease and Triggers for Intervention John N. Hamaty D.O. FACC, FACOI November 17 th 2017 I have no financial disclosures Primary Mitral
More informationChapter 24: Diagnostic workup and evaluation: eligibility, risk assessment, FDA guidelines Ashwin Nathan, MD, Saif Anwaruddin, MD, FACC Penn Medicine
Chapter 24: Diagnostic workup and evaluation: eligibility, risk assessment, FDA guidelines Ashwin Nathan, MD, Saif Anwaruddin, MD, FACC Penn Medicine Mitral regurgitation, regurgitant flow between the
More informationNext Generation Therapies: Aortic, Mitral and Beyond
Next Generation Therapies: Aortic, Mitral and Beyond Scott M Lilly, MD PhD Medical (Interventional) Director, Structural Heart Program Heart Summit, Lima OH August 26 th, 2017 Next Generation Therapies:
More informationIschemic Mitral Regurgitation
Ischemic Mitral Regurgitation Jean-Louis J. Vanoverschelde, MD, PhD Université catholique de Louvain Brussels, Belgium Definition Ischemic mitral regurgitation is mitral regurgitation due to complications
More informationEvolving Indications for Tricuspid Valve Surgery
Current Treatment Options in Cardiovascular Medicine (2010) 12:587 597 DOI 10.1007/s11936-010-0098-1 Valvular, Myocardial, Pericardial, and Cardiopulmonary Diseases Evolving Indications for Tricuspid Valve
More informationAssessing the Impact on the Right Ventricle
Advances in Tricuspid Regurgitation Congress of the European Society of Cardiology (ESC) Munich, August 25-29, 2012 Assessing the Impact on the Right Ventricle Stephan Rosenkranz, MD Clinic III for Internal
More informationUnderstanding the guidelines for Interventions in MR. Ali AlMasood
Understanding the guidelines for Interventions in MR Ali AlMasood Mitral regurgitation The most diverse from all acquired valve diseases About 50% of patients with an LVEF 35 percent had moderate to severe
More informationOrganic mitral regurgitation
The best in heart valve disease Organic mitral regurgitation Ewa Szymczyk Department of Cardiology Medical University of Lodz, Poland I have nothing to declare Organic mitral regurgitation leaflet abnormality
More informationIntroducing the COAPT Trial
physician INFORMATION Eligible patients Symptomatic functional mitral regurgitation 3+ Not suitable candidates for open mitral valve surgery NYHA functional class II, III, or ambulatory IV Introducing
More informationNeoChord Mitral Valve Repair. Department of Cardiac, Thoracic and Vascular Sciences University of Padua, Italy
NeoChord Mitral Valve Repair Department of Cardiac, Thoracic and Vascular Sciences University of Padua, Italy Disclosures Proctoring for Neochord Inc. NeoChord procedure Transapical off-pump mitral valve
More informationAortic valve repair: When and how to employ this novel approach?
Aortic valve repair: When and how to employ this novel approach? Konstadinos A Plestis, MD System Chief of Cardiac Thoracic and Vascular Surgery Main Line Health Care System Professor Sidney Kimmel Medical
More informationTricuspid leaflet repair: innovative solutions
Perspective Tricuspid leaflet repair: innovative solutions Jack H. Boyd 1, J. James B. Edelman 2, David H. Scoville 1, Y. Joseph Woo 1 1 Department of Cardiothoracic Surgery, Stanford University School
More informationManagement of Difficult Aortic Root, Old and New solutions
Management of Difficult Aortic Root, Old and New solutions Hani K. Najm MD, Msc, FRCSC,, FACC, FESC Chairman, Pediatric and Congenital Heart Surgery Cleveland Clinic Conflict of Interest None Difficult
More information