Minimally invasive approach for isolated tricuspid valve surgery.

BACKGROUND AND AIM OF THE STUDY

Isolated tricuspid valve surgery has been associated with a high morbidity and mortality. The study aim was to analyze the feasibility of a minimally invasive approach for isolated tricuspid valve surgery.

METHODS

A total of 2,945 heart operations performed at the authors' institution between January 2009 and April 2013 was retrospectively reviewed to identify patients who had undergone isolated, minimally invasive tricuspid valve surgery via a right mini-thoracotomy approach. Details of operative times, intensive care unit (ICU) and hospital lengths of stay, postoperative complications, and mortality were analyzed.

RESULTS

A total of 12 patients (eight females, four males; mean age 68 +/- 18 years) was identified. The median left ventricular ejection fraction was 58% (IQR 47-64%), and prior valve or coronary artery bypass graft surgery was noted in four patients (33%) and two patients (17%), respectively. Most of the patients underwent tricuspid valve repair (92%), with a median cardiopulmonary bypass time of 106 min (IQR 82-122 min). The median ICU and total hospital lengths of stay were 84 h (IQR 47-157 h) and 7 days (IQR 6-12 days), respectively. Postoperative complications included prolonged ventilation (50%), reintubation (17%), atrial fibrillation (17%), and acute kidney injury (8%). There were no postoperative cerebrovascular accidents, myocardial infarctions, reoperations for bleeding, or deep wound infections. The 30-day mortality rate was 17%, and two-year survival 67%.

CONCLUSION

A minimally invasive approach for isolated tricuspid valve surgery is feasible, with a high rate of valve repair.