PMID- 33798046
OWN - NLM
STAT- MEDLINE
DCOM- 20210914
LR  - 20210914
IS  - 1522-6662 (Electronic)
IS  - 1098-3511 (Linking)
VI  - 24
IP  - 2
DP  - 2021 Mar 8
TI  - CorMatrix Anterior Leaflet Augmentation of the Tricuspid Valve: Midterm Results.
PG  - E261-E266
LID - 10.1532/hsf.3599 [doi]
AB  - BACKGROUND: Tricuspid annuloplasty is the most common surgical approach to 
      correct tricuspid regurgitation (TR). In some patients, however, anterior leaflet 
      patch augmentation may be necessary to optimize tricuspid competence. We reviewed 
      our center cohort over the midterm and long term. METHODS: From January 2013 to 
      August 2018, 424 tricuspid valve procedures were performed, of which 420 were 
      repairs and 4 were replacements. Indications were either isolated severe TR or 
      moderate or greater TR, concomitant with other surgery. In the repair cohort, we 
      identified those that had a patch augmentation, and the database was interrogated 
      for preoperative characteristics. The resulting patients had outpatient 
      assessment (clinical and echocardiography) at 6 weeks and at a later interval. 
      Additionally, a comparison was made between those who had good and poor results 
      (moderate or greater TR or cardiac death). RESULTS: In the repair cohort, 19 
      patients underwent complex tricuspid valve repair with CorMatrix anterior leaflet 
      augmentation. Preoperative characteristics were as follows: age, 65.5 +/- 13.5 
      years; New York Heart Association (NYHA) class, 3.5 +/- 0.5; left ventricular 
      ejection fraction, 48.3% +/- 5.9%; tricuspid annular plane systolic excursion, 17.1 
      +/- 3.7 mm; right ventricle (good, mild, moderate, poor), 10, 5, 4, 0; annulus 
      size, 40.9 +/- 6.9 mm; mean tethering distance, 1.00 +/- 0.3 cm; and mean tethering 
      area, 1.53 +/- 1.16 cm2. Mean follow-up was 2.1 +/- 1.9 years, and survival at 2 
      years was 73.8%. There were 2 in-hospital deaths. Mean NYHA class was 1.0 +/- 0.5 
      (6 weeks) and 1.5 +/- 0.6 (later follow-up); mean residual TR grade was 0.5 +/- 0.6 
      (6 weeks) and 1.3 +/- 1.4 (follow-up). Ten of 13 survivors had a good result at 
      last follow-up (TR 0 to 1). We compared the preoperative and operative data of 
      this group versus those with poor results (TR >1 or cardiac mortality). 
      Significant univariate predictors of poor results were larger preoperative 
      tethering area (1.18 +/- 0.43 versus 2.4 +/- 1.5 cm2; P = .02), longer tethering 
      distance (0.87 +/- 0.21 versus 1.2 +/- 0.19 cm; P = .007), or the presence of mild or 
      greater TR at 6 weeks (0.2 +/- 0.4 vs 1.25 +/- 0.5; P = .03). CONCLUSIONS: CorMatrix 
      anterior leaflet augmentation produces successful, stable repair in the majority 
      of this complex population. The presence of even mild TR at 6 weeks' follow-up 
      predicts a poor result. When the tethering area or the tethering distance is 
      significantly high, replacement is probably a better option.
CI  - (c) 2021 Forum Multimedia Publishing, LLC
FAU - Rescigno, Giuseppe
AU  - Rescigno G
AD  - Cardiothoracic Department, Heart and Lung Centre, Royal Wolverhampton NHS Trust, 
      Wolverhampton, UK.
FAU - Hothi, Sandeep
AU  - Hothi S
AD  - Cardiology Department, Heart and Lung Centre, Royal Wolverhampton NHS Trust, 
      Wolverhampton, UK.
FAU - Bond, Christopher
AU  - Bond C
AD  - Cardiothoracic Department, Heart and Lung Centre, Royal Wolverhampton NHS Trust, 
      Wolverhampton, UK.
FAU - Uddin, Mauin
AU  - Uddin M
AD  - Cardiothoracic Department, Heart and Lung Centre, Royal Wolverhampton NHS Trust, 
      Wolverhampton, UK.
FAU - Bhatti, Veena
AU  - Bhatti V
AD  - Cardiac Investigation Department, Heart and Lung Centre, Royal Wolverhampton NHS 
      Trust, Wolverhampton, UK.
FAU - Billing, John Stephen
AU  - Billing JS
AD  - Cardiothoracic Department, Heart and Lung Centre, Royal Wolverhampton NHS Trust, 
      Wolverhampton, UK.
LA  - eng
PT  - Journal Article
DEP - 20210308
PL  - United States
TA  - Heart Surg Forum
JT  - The heart surgery forum
JID - 100891112
SB  - IM
MH  - Aged
MH  - Cardiac Valve Annuloplasty/*methods
MH  - Echocardiography/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume/*physiology
MH  - Time Factors
MH  - Treatment Outcome
MH  - Tricuspid Valve/diagnostic imaging/*surgery
MH  - Tricuspid Valve Insufficiency/diagnosis/physiopathology/*surgery
MH  - Ventricular Function, Left/*physiology
EDAT- 2021/04/03 06:00
MHDA- 2021/09/15 06:00
CRDT- 2021/04/02 17:13
PHST- 2021/01/09 00:00 [received]
PHST- 2021/01/22 00:00 [accepted]
PHST- 2021/04/02 17:13 [entrez]
PHST- 2021/04/03 06:00 [pubmed]
PHST- 2021/09/15 06:00 [medline]
AID - 10.1532/hsf.3599 [doi]
PST - epublish
SO  - Heart Surg Forum. 2021 Mar 8;24(2):E261-E266. doi: 10.1532/hsf.3599.