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MINIMALLY INVASIVE TRICUSPIDE VALVE SURGERY WITHOUT CAVAL OCCLUSION: SHORT AND MID-TERM RESULTS.
  • +6
  • Vito Margari,
  • Pietro Malvindi,
  • Adriano De Santis,
  • Kounakis Giorgio,
  • Giuseppe Visicchio,
  • Giuseppe Mastrototaro,
  • Pierpaolo Dambruoso,
  • CARMINE CARBONE,
  • Domenico Paparella
Vito Margari
Ospedale Santa Maria
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Pietro Malvindi
Ospedale Santa Maria
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Adriano De Santis
Ospedale Santa Maria
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Kounakis Giorgio
Ospedale Santa Maria
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Giuseppe Visicchio
Ospedale Santa Maria
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Giuseppe Mastrototaro
Ospedale Santa Maria
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Pierpaolo Dambruoso
Ospedale Santa Maria
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CARMINE CARBONE
Ospedale Santa Maria
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Domenico Paparella
Ospedale Santa Maria
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Abstract

Abstract Objectives: The use of minimally invasive or transcatheter interventions rather than standard full sternotomy operations to treat Tricuspid valve disease is increasing. Debate however is still open regarding venous drainage management during cardiopulmonary bypass and wheatear or not superior and inferior vena cava should be occluded during opening of the right atrium to avoid air entrance in the venous line. The aim of the present study is to report operative outcomes and mid-term follow-up results of minimally invasive tricuspid valve surgery performed without caval occlusion. Methods: This is a retrospective outcome evaluation from institutional records with prospective data entry. We searched for all the patients who underwent right mini-thoracotomy tricuspid valve surgery isolated or combined with mitral valve surgery during the period June 2013 – February 2020. Results: During the study period 68 consecutive patients underwent minimally invasive tricuspid valve surgery without occlusion of cava veins. Survival at a 5-year and 8-year follow up was 100% and 79%, respectively. At follow-up no patient had an NHYA class greater than two, only one patient was re-hospitalized for heart failure for an atrial fibrillation episode. One patient was hospitalized for a pericardiocentesis twenty days after discharge No severe tricuspid regurgitation was evident at echocardiographic follow up. Five patients had 2+ TR. Conclusion Our results show that performing tricuspid surgery without caval occlusion is safe. There is no clinical evidence of gas embolism. Mid-term follow up data confirm that minimally invasive approach does not alter the quality of surgery.

Peer review status:ACCEPTED

29 Sep 2020Submitted to Journal of Cardiac Surgery
08 Oct 2020Submission Checks Completed
08 Oct 2020Assigned to Editor
10 Oct 2020Reviewer(s) Assigned
24 Oct 2020Review(s) Completed, Editorial Evaluation Pending
26 Oct 2020Editorial Decision: Revise Major
15 Nov 20201st Revision Received
19 Nov 2020Assigned to Editor
19 Nov 2020Submission Checks Completed
19 Nov 2020Reviewer(s) Assigned
28 Nov 2020Review(s) Completed, Editorial Evaluation Pending
28 Nov 2020Editorial Decision: Revise Minor
06 Dec 20202nd Revision Received
07 Dec 2020Submission Checks Completed
07 Dec 2020Assigned to Editor
08 Dec 2020Reviewer(s) Assigned
14 Dec 2020Review(s) Completed, Editorial Evaluation Pending
14 Dec 2020Editorial Decision: Accept