Surgical technique and early results of tricuspid valve replacement with mitral homograft

Objective. To present the immediate results of tricuspid valve replacement with mitral homograft. Material and methods. We enrolled 21 patients who underwent surgery between September 2021 and April 2023 in 2 departments. Etiology of tricuspid insufficiency: infective (including prosthetic) endocarditis — 16 (76%), tumor thrombosis of inferior vena cava — 1 (5%), congenital heart disease — 2 (9%), bioprosthesis failure — 1 (5%), thrombosis of mechanical prosthesis — 1 (5%). There were 5 (24%) redo surgeries. All patients underwent tricuspid valve replacement with mitral homograft. We estimated intraoperative and early postoperative results, as well as primary endpoints. Results. Aortic cross-clamping and cardiopulmonary bypass time was 118.1±23.7 and 145.1±26.9 min, respectively. Concomitant procedures were performed in 4 patients. Postoperative complications included 2 (9.5%) cases of permanent pacemaker implantation, 3 (14.2%) cases of pneumonia. There were no 30-day mortality and other complications. Maximum and mean pressure gradient was 5 [5; 8] and 3 [2; 4] mm Hg. There were no significant changes in right and left ventricular systolic function after tricuspid valve replacement with homograft. Conclusion. We revealed excellent early hemodynamic and clinical results in tricuspid valve surgery with mitral homograft without significant changes in ventricular systolic function. Mitral homograft may be recommended as an alternative valve substitute in appropriate patients.