Optimal surgical management of severe tricuspid regurgitation in cardiac transplant patients

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Farzan FilsoufiDavid H Adams

Abstract

Severe tricuspid regurgitation (TR) with signs of right-sided heart failure is rare after orthotopic heart transplantation (OHT). In some instances, this condition will require surgical correction using reconstructive surgery or prosthetic valve replacement. Repair techniques of atrioventricular valves are now well described. However, the results of the different surgical procedures in this setting have not been widely reported and may depend on the type of valvular dysfunction and lesions present. Herein we report our experience in a group of patients requiring surgical correction of symptomatic severe TR after OHT. We reviewed our transplant experience during the period from July 1992 to July 1999 (n = 138 cardiac transplants). Eight patients (5.8%) developed symptomatic severe TR requiring surgical correction after a mean duration of 21 months after OHT. Patients were divided into 2 groups based on the mechanism of regurgitation using Carpentier's functional classification. In Group 1 (n = 4), the mechanism of tricuspid regurgitation was Carpentier's Type I, secondary to annular dilation. In Group 2 (n = 4) the mechanism of TR was leaflet prolapse (Type II), due to chordal rupture after biopsy injury. Initially, tricuspid va...Continue Reading

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Citations

Apr 13, 2010·The Journal of Thoracic and Cardiovascular Surgery·Heidi GoerlerMartin Strueber
Nov 21, 2015·International Journal of Cardiology·M PozziJ F Obadia
Apr 30, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·V Ben SivarajanJ William Gaynor
Mar 18, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Raymond Ching-Chiew WongDavid Taylor
Dec 11, 2007·International Journal of Cardiology·María MartínCésar Morís de la Tassa
Mar 10, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Stephane DoutreleauBernard Geny
Apr 12, 2016·International Journal of Cardiology·Entela BollanoGöran Dellgren
Aug 9, 2016·Transplantation Proceedings·T UrbanowiczM Jemielity
Apr 15, 2015·World Journal for Pediatric & Congenital Heart Surgery·F Bennett PearceJames K Kirklin
Nov 12, 2016·World Journal for Pediatric & Congenital Heart Surgery·James K KirklinF Bennett Pearce
Nov 16, 2017·Transplantation Direct·Johannes GoeklerArezu Aliabadi-Zuckermann
Feb 8, 2007·Current Opinion in Cardiology·Mitesh V Badiwala, Vivek Rao
Nov 26, 2019·The Journal of Thoracic and Cardiovascular Surgery·Fabio IusSerghei Cebotari
Jul 6, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Geoffrey C RamsdellHarish Ramakrishna

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