Key result
Tricuspid valve detachment for VSD closure yields similar mild TR rates versus standard closure.
Why the study?
Does tricuspid valve detachment safely facilitate ventricular septal defect closure without increasing complications?
Cohort (n=35)
No
Does tricuspid valve detachment safely facilitate ventricular septal defect closure without increasing complications?
Absolute Event Rate: 45% vs 27%
p-value: p=0.48
Tricuspid valve detachment during VSD closure increases procedural times but appears safe with no significant increase in tricuspid regurgitation or atrioventricular block at midterm follow-up.
TVD during VSD closure prolongs bypass times without higher TR rates; leaves open safety and benefit in randomized trials.
BACKGROUND: Tricuspid valve detachment (TVD) may improve the access for closing certain ventricular septal defects (VSDs), but it has some potential risks. We aimed to study the benefits and drawbacks of this technique. METHODS: The midterm outcomes of all 20 patients who underwent a TVD closure for VSD were reviewed and compared with a control group of 15 patients with VSD closure without TVD. RESULTS: There was no significant residual shunt in either group at the last actuarial follow-up. Tricuspid regurgitation occurred in both groups (45% in the TVD group and 27% in the control group, P = .48). These lesions were considered insignificant in all patients. There were no atrioventricular blocks, and all patients were in sinus rhythm. The cardiopulmonary bypass times were significantly higher in the TVD group than in the control group (91.6 ± 17.2 minutes versus 68.3 ± 15.7 minutes, P ≤ .01), as were the aortic cross-clamping times (50.7 ± 12.1 minutes versus 35.9 ± 14.4 minutes, P ≤ .01). CONCLUSION: Our results, along with results from other series, suggest that TVD can be used effectively and safely for closure of certain VSDs.
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Weymann et al. (2013) conducted a cohort in Ventricular septal defect (n=35). Tricuspid valve detachment vs. Transatrial VSD closure without tricuspid valve detachment was evaluated on Tricuspid regurgitation at follow-up (p=0.48). Tricuspid valve detachment for ventricular septal defect closure resulted in no significant residual shunts or heart block, and similar rates of mild tricuspid regurgitation compared to standard closure (45% vs 27%, P=0.48).
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