Key result
Minimally invasive isolated tricuspid redo surgery shows ~99% success with fewer complications than median sternotomy.
Why the study?
Reoperation for isolated tricuspid valve surgery is considered high risk, and the optimal surgical approach remains controversial.
Does minimally invasive isolated tricuspid valve redo surgery improve clinical outcomes compared to median sternotomy in patients with previous cardiac surgery?
Cohort (n=119)
No
Does minimally invasive isolated tricuspid valve redo surgery improve clinical outcomes compared to median sternotomy in patients with previous cardiac surgery?
Minimally invasive approaches for isolated tricuspid valve redo surgery appear safe and may offer better clinical outcomes with fewer complications compared to median sternotomy.
Minimally invasive redo TV surgery was associated with fewer complications; leaves open need for randomized trials before practice change.
BACKGROUND: Reoperation for isolated tricuspid valve (TV) surgery is considered a high-risk procedure. The optimal surgical approach is controversial. We analyzed our experience with isolated TV redo surgery performed either through thoracoscopic approach (thoracoscopic group), right thoracotomy (thoracotomy group), or median sternotomy (sternotomy group). METHODS: We retrospectively analyzed all patients with previous cardiac surgery who underwent redo-TV procedure through thoracoscopic approach (n = 33), right lateral thoracotomy approach (n = 14), or sternotomy (n = 72). RESULTS: All patients successfully underwent elective surgery, with no intraoperative conversion or death occurring. 69% and 31% of patients received valve replacement and valvuloplasty, respectively. After operation, one patient in the sternotomy group received reoperation for bleeding, while another patient received valve replacement surgery 2 weeks after operation due to heart failure caused by valvuloplasty failure. No obvious complications occurred in the minimally invasive groups. The overall success rate of valve repair during 1-year follow-up was 99.2%. CONCLUSION: Minimally invasive, isolated TV surgery as reoperation can be safe and may improve clinical outcome.
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Wei et al. (2020) conducted a cohort in Isolated tricuspid valve redo surgery (n=119). Minimally invasive approach (thoracoscopic or right lateral thoracotomy) vs. Median sternotomy was evaluated on Complications and overall success rate of valve repair. Minimally invasive isolated tricuspid valve redo surgery had no obvious complications, compared to two major complications in the sternotomy group, with a 99.2% overall success rate at 1 year.
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