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Nuzhdin M.D.

Chelyabinsk Regional Clinical Hospital;
South Ural State Medical University

Komarov R.N.

Sechenov First Moscow State Medical University

Nadtochiy N.B.

Chelyabinsk Regional Clinical Hospital

Matsuganov D.A.

Chelyabinsk Regional Clinical Hospital

Tsarkov A.V.

Chelyabinsk Regional Clinical Hospital

Fokin A.A.

South Ural State Medical University

Surgical technique and early results of tricuspid valve replacement with mitral homograft

Authors:

Nuzhdin M.D., Komarov R.N., Nadtochiy N.B., Matsuganov D.A., Tsarkov A.V., Fokin A.A.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(5): 499‑505

DOI: 10.17116/kardio202417051499

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Table of contents

To cite this article:

Nuzhdin MD, Komarov RN, Nadtochiy NB, Matsuganov DA, Tsarkov AV, Fokin AA. Surgical technique and early results of tricuspid valve replacement with mitral homograft. Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(5):499‑505. (In Russ.)
https://doi.org/10.17116/kardio202417051499

Подписка 2025 (Russian Journal of Cardiology and Cardiovascular Surgery)
 
МСФ на ЯМ
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OBJECTIVE

To present the immediate results of tricuspid valve replacement with mitral homograft.

MATERIAL AND METHODS

We enrolled 21 patients who underwent surgery between September 2021 and April 2023 in 2 departments. Etiology of tricuspid insufficiency: infective (including prosthetic) endocarditis — 16 (76%), tumor thrombosis of inferior vena cava — 1 (5%), congenital heart disease — 2 (9%), bioprosthesis failure — 1 (5%), thrombosis of mechanical prosthesis — 1 (5%). There were 5 (24%) redo surgeries. All patients underwent tricuspid valve replacement with mitral homograft. We estimated intraoperative and early postoperative results, as well as primary endpoints.

RESULTS

Aortic cross-clamping and cardiopulmonary bypass time was 118.1±23.7 and 145.1±26.9 min, respectively. Concomitant procedures were performed in 4 patients. Postoperative complications included 2 (9.5%) cases of permanent pacemaker implantation, 3 (14.2%) cases of pneumonia. There were no 30-day mortality and other complications. Maximum and mean pressure gradient was 5 [5; 8] and 3 [2; 4] mm Hg. There were no significant changes in right and left ventricular systolic function after tricuspid valve replacement with homograft.

CONCLUSION

We revealed excellent early hemodynamic and clinical results in tricuspid valve surgery with mitral homograft without significant changes in ventricular systolic function. Mitral homograft may be recommended as an alternative valve substitute in appropriate patients.

Keywords:

homograft
tricuspid valve replacement
infective endocarditis

Authors:

Nuzhdin M.D.

Chelyabinsk Regional Clinical Hospital;
South Ural State Medical University

Komarov R.N.

Sechenov First Moscow State Medical University

Nadtochiy N.B.

Chelyabinsk Regional Clinical Hospital

Matsuganov D.A.

Chelyabinsk Regional Clinical Hospital

Tsarkov A.V.

Chelyabinsk Regional Clinical Hospital

Fokin A.A.

South Ural State Medical University

Received:

10.06.2023

Accepted:

11.07.2023

List of references:

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  2. Condello F, Gitto M, Stefanini GG. Etiology, epidemiology, pathophysiology and management of tricuspid regurgitation: an overview. Rev Cardiovasc Med. 2021;22(4):1115-1142. https://doi.org/10.31083/j.rcm2204122
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  10. Couetil JP, Argyriadis PG, Shafy A, et al. Partial replacement of the tricuspid valve by mitral homografts in acute endocarditis. Ann Thorac Surg. 2002;73(6):1808-1812. https://doi.org/10.1016/s0003-4975(02)03574-9
  11. Kirklin JK. Challenging homografts as the holy grail for aortic valve endocarditis. J Thorac Cardiovasc Surg. 2016;151(5):1230-1231. https://doi.org/10.1016/j.jtcvs.2015.12.009
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