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256402

Rheumatic tricuspid valve disease: Repair versus Replacement

Article

Last updated: 27 Dec 2024

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Subjects

-

Tags

Cardiothoracic Surgery.

Abstract

Background: Tricuspid valve disease is most commonly functional, however, organic affection still accounts for one fourth of cases. Rheumatic fever which is endemic in Egypt is a main cause of organic affection. Current practice largely relies on tricuspid valve repair; however, it has been difficult to determine optimal procedure.
Objectives: Herein, we study the outcome of replacement versus repair in such patients.
Patients and methods: A prospective study was conducted on 300 consecutive patients with rheumatic heart disease showing severe tricuspid valve affection underwent tricuspid valve surgery, between 2014 and 2018. The patients were divided into two groups; TVR group (n=150) which included patients who underwent tricuspid valve replacement and TVr group (n=150) which included patients who underwent tricuspid valve repair. Diagnosis and follow up were done by echocardiography. Peri-operative variables, clinical outcome, morbidity, mortality, and follow up data were recorded.
Results: Mean follow-up was 4±1.32 years. In-hospital mortality was 6 patients (4%) in TVR group and 3 patients (2%) in TVr group (P value ≥ 0.05). Postoperative low cardiac output syndrome and stroke were significantly higher in the repair group. Postoperative RV dysfunction, renal impairment, renal failure and chest re-exploration were significantly higher in the replacement group. Severe tricuspid regurgitation was reported in 19 patients (12.6%) of the repair group on follow up.
Conclusion: Tricuspid valve repair is preferable to replacement to avoid the drawbacks of prosthesis. However, tricuspid valve replacement is feasible with comparable survival outcome and the progressive nature of the rheumatic disease may recommend replacement.

DOI

10.21608/svuijm.2022.155076.1372

Keywords

Rheumatic valve disease, Primary tricuspid valve disease, Tricuspid valve repair, Tricuspid valve replacement, Outcome

Authors

First Name

Ahmed M.

Last Name

Elwakeel

MiddleName

-

Affiliation

Department of Cardio-Thoracic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt.

Email

aelwakeel@cu.edu.eg

City

-

Orcid

0000-0003-2877-3446

First Name

Ashraf A.H.

Last Name

El Midany

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Ain-Shams University Hospital, Faculty of Medicine, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Ismail N.

Last Name

El-Sokkary

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Mohamed El-Hossiny

Last Name

Mahmoud

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Bahaa A.

Last Name

Elkhonezy

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Haytham M.

Last Name

Abdelmoaty

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Ain-Shams University Hospital, Faculty of Medicine, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Mohammed Wael

Last Name

Badawi

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Ain-Shams University Hospital, Faculty of Medicine, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Tamer

Last Name

Hikal

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Mohamed H.

Last Name

Ahmed

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Ain-Shams University Hospital, Faculty of Medicine, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Ahmed A.

Last Name

Khaled

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Military Medical Academy, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Mohammed E.

Last Name

ElSaid

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Ain-Shams University Hospital, Faculty of Medicine, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Ibrahim K.

Last Name

Gamil

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Ain-Shams University Hospital, Faculty of Medicine, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Mahmoud

Last Name

khadrawy

MiddleName

-

Affiliation

Department of Cardiovascular & Thoracic Surgery, Nasser Institute, Cairo, Egypt.

Email

-

City

-

Orcid

-

First Name

Mahmoud

Last Name

Elwakeel

MiddleName

-

Affiliation

Department of Anesthesia, Surgical ICU, and pain management, Faculty of Medicine, Cairo University, Giza, Egypt.

Email

drwakeel@gmail.com

City

-

Orcid

0000-0003-0818-9605

First Name

Eman

Last Name

Mahmoud

MiddleName

-

Affiliation

Department of Cardiology, Fayoum University, Fayoum, Egypt.

Email

-

City

-

Orcid

-

First Name

Ahmed H.

Last Name

Lamloom

MiddleName

-

Affiliation

Department of Cardio-Thoracic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt.

Email

alamloumcts@gmail.com

City

-

Orcid

-

Volume

5

Article Issue

2

Related Issue

31287

Issue Date

2022-07-01

Receive Date

2022-08-09

Publish Date

2022-07-01

Page Start

428

Page End

441

Print ISSN

2735-427X

Online ISSN

2636-3402

Article File

SVUIJM_Volume 5_Issue 2_Pages 428-441.pdf

PDF . 214.6kB

Link

https://svuijm.journals.ekb.eg/article_256402.html

Detail API

https://svuijm.journals.ekb.eg/service?article_code=256402

Order

43

Type

Original research articles

Type Code

1,520

Publication Type

Journal

Publication Title

SVU-International Journal of Medical Sciences

Publication Link

https://svuijm.journals.ekb.eg/

MainTitle

Rheumatic tricuspid valve disease: Repair versus Replacement

Details

Type

Article

Created At

23 Jan 2023