Management of tricuspid regurgitation in congenital heart disease: Is survival better with valve repair? Sameh M. Said, MD, Joseph A. Dearani, MD, Harold.

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Presentation transcript:

Management of tricuspid regurgitation in congenital heart disease: Is survival better with valve repair? Sameh M. Said, MD, Joseph A. Dearani, MD, Harold M. Burkhart, MD, Heidi M. Connolly, MD, Ben Eidem, MD, Paul E. Stensrud, MD, Hartzell V. Schaff, MD The Journal of Thoracic and Cardiovascular Surgery Volume 147, Issue 1, Pages 412-419 (January 2014) DOI: 10.1016/j.jtcvs.2013.08.034 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Kaplan-Meier graphs showing (A) the overall survival of patients after tricuspid valve surgery, and (B) survival difference between tricuspid valve repair and replacement groups. TVR, Tricuspid valve replacement; TV, tricuspid valve. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 412-419DOI: (10.1016/j.jtcvs.2013.08.034) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Kaplan-Meier graphs showing late survival of patients after tricuspid valve replacement with mechanical versus biologic valves. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 412-419DOI: (10.1016/j.jtcvs.2013.08.034) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A and B, Pathologic specimens and (C) intraoperative photograph showing perforation or entanglement of the tricuspid valve leaflet with pacemaker or cardioverter-defibrillators lead (arrows). Reprinted with permission.1 The Journal of Thoracic and Cardiovascular Surgery 2014 147, 412-419DOI: (10.1016/j.jtcvs.2013.08.034) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A-C, In the presence of pacemaker or cardioverter defibrillator leads, repair techniques vary and depend on the degree of damage of leaflets. In the absence of extensive leaflet damage, valve repair is preferred. It usually involves removing (incising) the lead away from the damaged leaflet, and suture repair of the leaflet defect if present and repositioning the lead by suture fixation against the annulus. Most often suture fixation is in the recess of either the inferoseptal or anteroinferior commissure. Finally, ringed annuloplasty is performed. Reprinted with permission.1 The Journal of Thoracic and Cardiovascular Surgery 2014 147, 412-419DOI: (10.1016/j.jtcvs.2013.08.034) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions