Partial replacement of tricuspid valve using cryopreserved homograft

Ann Thorac Surg. 2010 Apr;89(4):1187-94. doi: 10.1016/j.athoracsur.2009.12.047.

Abstract

Background: The optimal choice of prosthesis for tricuspid valve (TV) replacement is yet to be determined. Partial replacement of the TV using a homograft atrioventricular valve might offer resistance to infection, good durability, and excellent functionality, in addition to avoiding prosthesis-related morbidity.

Methods: We present 14 patients who underwent replacement of the TV using a homograft between 1997 and 2008. The mean age at operation was 32 years, including 5 patients younger than the age of 10. All patients preoperatively showed severe TV regurgitation as a result of active infective endocarditis in 5 patients, Ebstein anomaly in 4 patients, other cardiac anomalies in 4 patients, and rheumatic valvular disease in 1 patient. The TV homograft was used in 13 patients, and mitral homograft was used in 1 patient. Eleven patients had replacement of one leaflet only, whereas 3 patients required replacement of two leaflets. Concomitant cardiac procedures were performed in 7 patients.

Results: No mortalities occurred during the average postoperative follow-up of 61 months (range, 12 to 126 months). Reoperation for TV regurgitation after TV repair with homograft was performed in 3 patients. The remaining 11 patients had minimal symptoms without reintervention for TV regurgitation.

Conclusions: Partial replacement of the TV using a homograft provided good hospital and mid-term outcomes. This strategy might be useful in active infective endocarditis and congenital TV disease.

MeSH terms

  • Adult
  • Aged
  • Cardiac Surgical Procedures / methods
  • Child
  • Cryopreservation*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Mitral Valve / surgery
  • Mitral Valve / transplantation*
  • Mitral Valve Insufficiency / surgery*
  • Time Factors
  • Treatment Outcome
  • Tricuspid Valve / surgery
  • Tricuspid Valve / transplantation*
  • Tricuspid Valve Insufficiency / surgery*
  • Young Adult