Barbero, Cristina

Boffini, Massimo

Calia, Caludia

Cura Stura, Erik

Dyrda, Alessandro

Marchetto, Giovanni

Ricci, Davide

Rinaldi, Mauro

English

Cristina Barbero

Massimo Boffini

Caludia Calia

Erik Cura Stura

Alessandro Dyrda

Giovanni Marchetto

Davide Ricci

Mauro Rinaldi

PORTO@iris (Publications Open Repository TOrino - Politecnico di Torino)

04 August 2020POLITECNICO DI TORINORepository ISTITUZIONALEMinimally invasive tricuspid valve surgery in high risk patients / Barbero, Cristina; Boffini, Massimo; Calia, Caludia; CuraStura, Erik; Dyrda, Alessandro; Marchetto, Giovanni; Ricci, Davide; Rinaldi, Mauro. - (In corso di stampa). ((Interventopresentato al convegno 33 EACTS.OriginalMinimally invasive tricuspid valve surgery in high risk patientsPublisher:PublishedDOI:Terms of use:openAccessPublisher copyright(Article begins on next page)This article is made available under terms and conditions as specified in the  corresponding bibliographic description inthe repositoryAvailability:This version is available at: 11583/2760035 since: 2019-10-13T17:06:49ZOxford university pressMinimally invasive Tricuspid valve surgery in high risk patients • 001177 Background / Study Objective • Minimally invasive surgery has been an increasingly  success in recent years and excellent results have been published in correlation with mitral valve surgery • In literature there is not a large series of study about minimally invasive tricuspid valve surgery and the outcomes after this approach have not been well described. Even the latest ESC/AHA guidelines have not been expressed about the use of minimally invasive techniques • In the era of increasing adoption of catheter-based treatments, this study analyzed our 12-year experience with minimally invasive TV operations.  Patients From November 2005 to June 2018, Minimally Invasive TV surgery was performed in 209 patients Methods Results 1 • Mean Cardiopulmonary bypass (CPB) time was 146.5 ± 49.5, the mean cross clamp was 90.1 ±  36.6. In patients with isolated tricuspid CPB time was 102.0 ± 26.9, while the mean cross clamp was 48.3 ± 31.6. • Conversion to sternotomy was necessary in 6 patients (2.8%), in half of the cases it occurred, at the beginning, as a result of tenacious adhesions.   • Reoperation for bleeding was necessary in 19 (9.1%) cases, of which 15 were redo, and blood transfusion in 100 (47.8%) patients.  • Stroke complication occurred only in 2 (0.9%) patients, PMr implantation in 15 (7.2%), hemodialysis for acute renal failure in 10 (4.8%), new onset of atrial fibrillation in 16 (28.1%) and groin wound infection or lymphocele in 5 (2.4%).   • Mean Intensive care unit stay was 3.6 ± 11.3 days (median 1.0 day). Mean Ventilation time was 40.5 ± 245.2 hours (median 12.0 h).  Mean hospital stay was 11,9 ± 12,8 days (median 8.0 days).  • Overall hospital mortality was 3.8%. Intraoperative death occurred in 1 patient due to hemorrhagic shock. Other causes of death were multi-organ failure in 5 patients and sepsis in 2. 30- day mortality after TV repair was 2.1% (3/143) compared to 7.6 % (5/66) after TV replacement while after TV isolated procedure was 1.6% (1/61) compared to TV associated procedures 4.7% (7/148).  • At the early postoperative TEE evaluation trivial or no regurgitation was identified.  • Freedom from early re-operation for TV disease was 100%.  Results 2 Conclusion • Minimally invasive Tricuspid surgery is safe, feasible and reproducibile, even for hight- risk population.  • It ensure low perioperative morbidity and mortality. It has an added value in case of reoperative procedures • In our centre it represents the gold standard and the standard technique of TV surgery. • Minimally invasive TV Surgery should be considered the benchmark for new hybrid catheter-based technologies 

Minimally invasive tricuspid valve surgery in high risk patients

https://iris.polito.it/retrieve/handle/11583/2760035/278979/Minimally%20Invasive%20TV%20Surgery%202019%5b1657%5d.pdf

Minimally invasive tricuspid valve surgery in high risk patients

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