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Medline ® Abstract for Reference 41

of 'Management and prognosis of tricuspid regurgitation'

Partial replacement of tricuspid valve using cryopreserved homograft.
Shrestha BM, Fukushima S, Vrtik M, Chong IH, Sparks L, Jalali H, Pohlner PG
Ann Thorac Surg. 2010;89(4):1187.
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.
Division of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Australia. bishwo_shrestha@health.qld.gov.au