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The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant

Frontiers of Medicine 2023年第3期17卷 527-533页

作者： Kevin M.Veen Grigorios Papageorgiou Casper F.Zijderhand Mostafa M.Mokhles Jasper J.Brugts Olivier C.Manintveld Alina A.Constantinescu Jos A.Bekkers Johanna J.Makkenberg Ad J.J.CBogers Kadir Caliskan Department of Cardiothoracic Surgery Erasmus MC3000 CA RotterdamThe Netherlands Department of Biostatistics Erasmus MC3000 CA RotterdamThe Netherlands Department of Cardiology Erasmus MC3000 CA RotterdamThe Netherlands

In this study,we aim to elucidate the clinical impact and long-term course of tricuspid regurgitation(TR),taking into account its dynamic nature,after biatrial orthotopic heart transplant(OHT).All consecutive adult patients undergoing biatrial OHT(1984−2017)with an available follow-up echocardiogram were ***-models were used to model the evolution of *** mixed-model was inserted into a Cox model in order to address the association of the dynamic TR with *** total,572 patients were included(median age:50 years,males:74.9%).Approximately 32% of patients had moderate-to-severe TR immediately after ***,this declined to 11%on 5 years and 9% on 10 years after surgery,adjusted for survival *** mechanical support was associated with less TR during follow-up,whereas concurrent LV dysfunction was significantly associated with more TR during *** at 1,5,10,20 years was 97%±1%,88%±1%,66%±2% and 23%±2%,*** presence of moderate-to-severe TR during follow-up was associated with higher mortality(HR:1.07,95%CI(1.02–1.12),p=0.006).The course of TR was positively correlated with the course of creatinine(R=0.45).TR during follow-up is significantly associated with higher mortality and worse renal ***,probability of TR is the highest immediately after OHT and decreases ***,it may be reasonable to refrain from surgical intervention for TR during earlier phase after OHT.

关键词： orthotopic heart transplant tricuspid regurgitation clinical impact biatrial heart transplantation

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Pulmonary and tricuspid regurgitation after Tetralogy of Fallot repair: A case report

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World Journal of Cardiology 2023年第12期15卷 642-648页

作者： Jing-Yi Cao Xiao-Ping Ning Guang-Wei Zhou Bai-Ling Li Fan Qiao Lin Han Zhi-Yun Xu Fang-Lin Lu Department of Cardiovascular Surgery Changhai HospitalShanghai 200433China Department of Cardiovascular Surgery Shanghai General HospitalShanghai 200080China

BACKGROUND Tetralogy of Fallot(TOF)is one of the most common congenital heart defects,and surgery is the primary *** are no precise guidelines on the treatment protocol for tricuspid regurgitation(TR)as a common complication of TOF *** timing for treatment in patients presenting with valve regurgitation after TOF repair is often difficult to ***,we report the first case of sequential treatment of pulmonary and TR using interventional *** SUMMARY We present the case of a 52-year-old female patient,who had a history of TOF repair at a young age.A few years later,the patient presented with pulmonary and tricuspid *** symptoms persisted and TR worsened following percutaneous pulmonary valve *** testing revealed that the patient’s disease had advanced to an intermediate to advanced stage and that her general health was *** open-heart surgery was not an option for the patient,transcatheter tricuspid valve replacement was *** procedure was successful,and the patient recovered fully without any adverse *** case report may serve as a useful resource for planning future *** Treatment of both valves should be considered in patients with tricuspid and pulmonary regurgitations following TOF *** interventional strategy could be an alternative for patients with poor general health.

关键词： Tetralogy of Fallot repair Pulmonary regurgitation tricuspid regurgitation Interventional treatment Sequential treatment Case report

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Percutaneous establishment of tricuspid regurgitation： an experimental model for transcatheter tricuspid valve replacement

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Chinese Medical Journal 2010年第7期123卷 806-809页

作者： BAI Yuan CHEN Hai-yan ZONG Gang-jun JIANG Hai-bing LI Wei-ping WU Hong ZHAO Xian-xian QIN Yong-wen Department of Cardiology Changhai Hospital Second Military Medical University Shanghai 200433China Department of Cardiology Changzheng Hospital Second Military Medical University Shanghai 200003 China Department of Cardiology Changhai Hospital Second Military Medical University Shanghai 200433China Department of Ultrasonography Changhai Hospital Second Military Medical University Shanghai 200433China

Background Valve replacement or repair Is recommended in patients with tricuspid regurgitation when deterioration of their clinical status occurs as a consequence of right ventricular dysfunction. Percutaneous valve replacement was developed in recent years. To investigate the feasibility, effectiveness and long-term results of percutaneous tricuspid valve replacement, an experimental model with tricuspid regurgitation is needed. We developed a simple and reproducible percutaneous approach for the creation of tricuspid regurgitation in *** A specially designed grasping forceps were used to grasp chordae tendineae or the tricuspid valve leaflets through a catheter. Transcatheter creation of tricuspid regurgitation was performed on 7 healthy sheep. These sheep were followed up shortly after the procedure and at 6th month post-procedure with echocardiography. Additionally, all the sheep were sacrificed for anatomic evaluation at 6th month after the *** Creation of tricuspid regurgitation was successfully accomplished in all sheep. Necropsy confirmed that damage was done to the tricuspid valve apparatus in all animals （tearing of the anterior leaflet of the tricuspid valve in five animals and posterior leaflet of the tricuspid valve in two animals）. At the six-month follow-up, there was no significant increase in the right ventricle dimension and ejection fraction measured by echocardiography. Autopsy examinations demonstrated the tearing of tricuspid valve *** The creation of an animal model of tricuspid regurgitation via a percutaneous approach using forceps to sever one or more tricuspid leaflets is feasible and will allow investigation of devices designed replace the tricuspid valve via a percutaneous approach. Despite significant tricuspid regurgitation, the hemodynamics did not change during the follow-up period in this model.

关键词： tricuspid regurgitation percutaneous, animal model

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Management of“Wall to Wall Heart”in a Transient Neonatal tricuspid regurgitation

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Congenital Heart Disease 2021年第3期16卷 205-210页

作者： Elio Caruso Silvia Farruggio Davide Calvaruso David Fabio Petruccelli David Angel Ortiz Ruiz Corrado Di Mambro Salvatore Agati Mediterranean Pediatric Cardiology Center“Bambino Gesù” San Vincenzo HospitalTaorminaItaly

We present a case of a one-day-old newborn,without prenatal diagnosis,referred to our cardiologic intensive care unit in critical condition presenting sub-cyanosis and peripheral oxygen saturation of 80%.Echocardiography diagnosis was tricuspid valve dysplasia with severe regurgitation,functional pulmonary valve atresia with intact ventricular septum and reversal flow in the large patent ductus arteriosus(PDA).Chest X-ray showed severe cardiomegaly and wall to wall *** E1 infusion was started once after *** few days,clinical conditions progressively worsened because of right heart failure;a first pharmacological approach to close PDA failed and surgery ligation of PDA was necessary to restore anterograde pulmonary flow and heart size.

关键词： Wall to wall heart tricuspid regurgitation pulmonary atresia arterial duct

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Outcomes of Ebstein＇s Anomaly Patients Treated with tricuspid Valvuloplasty or tricuspid Valve Replacement：Experience of a Single Center

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Chinese Medical Journal 2018年第9期131卷 1067-1074页

作者： Bin Li Han-Song Sun Shi-Wei Pan Jian-Ping Xu Department of Cardiac Surgery State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Disease Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing 100037 China

Background：The incidence of Ebstein＇s anomaly is extremely low,and except for the Mayo Clinic,no cardiac center has reported on a sufficient number of *** aim of our study was to report the outcomes of Ebstein＇s anomaly patients treated with tricuspid valvuloplasty （TVP） or tricuspid valve replacement （TVR）.Methods：TVP or TV R was performed in 245 patients from July 2006 to April *** reviewed patients＇ records and contacted patients via outpatient service and over the ***：The mean follow-up time was 43.6 ± 32.6 months,and 224 （91.4％） patients underwent *** mean operative age was 31.2 ± 15.7 *** was performed in 23 patients,and TVP was performed in 201 *** 30-day mortality rate was 1.3％,and the overall survival rate was 97.9％ at 5 and l0 *** early mortality rate of the TVP group was lower than that of the TVR group （0.5％ vs.8.7％,P =0.028）,and the overall mortality rate of the TVP group was lower than that of the TVR group,without statistical significance （1.0％ vs.8.7％）.After propensity score matching,the rates of mortality and New York Heart Association class ≥Ⅲ were lower in the TVP group than those in the TVR group without statistical *** patients with Type B Wolff-Parkinson-White （WPW） syndrome underwent one-stage surgery,and arrhythmias *** patients suffered from episodes of left ventricular outflow tract obstruction （LVOTO） during *** LVOTO could be treated with reoperation of the atrialized right ***：Ebstein＇s anomaly patients treated with TVP or TVR can experience optimal outcomes with midterm ***,TVP should be the first-choice *** outcomes can be obtained from one-stage operation in patients with Type B WPW *** LVOTO during surgery might be related to improper operation of the atrialized right ventricle.

关键词： Congenital Heart Disease Right Heart Failure tricuspid regurgitation tricuspid Valve Dysplasia

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Right Ventricular Endomyocardial Fibrosis in Neonate—A Case Report

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Case Reports in Clinical Medicine 2016年第5期5卷 170-175页

作者： Ramachandran Muthiah Thoothukudi Medical College Hospital Thoothukudi India

Endomyocardial fibrosis is characterized by the formation of fibrous tissue in the endocardium. Although the disease may affect both ventricles, isolated or not, the right ventricle is more frequently involved. Endocardial fibrosis may be present in the entire ventricular cavity, being usually more marked in the apical region and right ventricular inflow tract. Its etiology, however, still remains unknown. Background—Reports on endomyocardial fibrosis in pediatric patients are not common. It is more frequent from the fourth year of age on, with few reports in the first 2 years of life. This case aimed at reporting right ventricular endomyocardial fibrosis in 7 days old male neonate, in addition to discussing the etiopathogenesis and future perspective of the disease.

关键词： Apical Fibrosis Right Ventricle tricuspid regurgitation Echocardiography Neonate

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The effect of transanular patch for the primary correction of tetralogy of Fallot in adulthood

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South China Journal of Cardiology 2015年第2期16卷 72-79,87页

作者：何标川聂志强陈寄梅刘小清曲艳吉欧艳秋岑坚正许刚温树生 Department of Cardiac Surgery Department of Cardiac Surgery Guangdong Provincial Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Division of Epidemiology Department of Cardiac Surgery Guangdong Provincial Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences

Baekground Although a lot of studies have been performed on the long term outcome in adults with repaired tetralogy of Fallot （TOF） in developed countries, but rare information for primary correction of adult TOF is available. The research focusing on the effect of transanular patch （TAP） for primary correction of TOF in adulthood is still absent. Via retrograde analysis of 7-year follow-up, this study was designed to explore the effect of the transanular patch for primary correction in adult TOF on the surgical outcome, postoperative cardiac function and morbidity, as well as to address the management of the complication. Methods A total of 151 consecutive adult patients （age ≥ 18） who underwent primary radical correction of TOF form 2007-2014 were selected and divided into TAP demographic statistic characteristics, and non-TAP groups based on the EACTS database. Results of echocardiography, color-Doppler echocardiography, cardiovascular enhanced contrast computed tomography （CT）, and/or cardiac catheterization; intraoperative information, postoperative results and outcomes were reported. During follow-up, short term was defined within 3 months after discharge, and midterm was defined as 6-12 months after discharge. Results Total postoperative mortality was 5.96% in all the cases, 6.96% in TAP group, and 2.78% （1/36） in non-TAP group. There was no significant difference between two groups. Follow-up period ranged from 3 months to 62 months. Readmission occurred and was followed by medical treatment without re-do surgery in 6 cases （3.97%）. The short term echocardiography demonstrated that pulmonary regurgitation and short term tricuspid regurgitation after discharge in TAP group were more severe （P 〈 0.001）. The short term residual pulmonary stenosis （RVOTO） severity after discharge in TAP group was less severe （P = 0.018）. Midterm echocardiography after discharge demonstrated pulmonary regurgitation and tricuspid regurgitation in TAP group were still more severe （

关键词： adult tetralogy of Fallot transanular patch pulmonary regurgitation tricuspid regurgitation right ventricular outflow tract obstruction repeated cardiopulmonary bypass

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