Effectiveness of Artificial Neochordae Implantation in Tricuspid Valve Repair

Overview

Journal Tex Heart Inst J

Specialty Cardiology & Vascular Diseases

Date 2019 Jun 26

PMID 31236073

Citations 1

Authors

Salih Salihi

H Tarik Kiziltan

Ahmad Huraibat

Askin Ali Korkmaz

Ibrahim Kara

Mustafa Guden

Affiliations

Soon will be listed here.

Abstract

Various techniques for treating tricuspid regurgitation have been described; however, because of scarce data about the long-term outcomes of different repairs, the optimal technique has not been established. We evaluated the effectiveness and durability of artificial neochordae implantation in the treatment of tricuspid regurgitation. From 2009 through 2014, 507 patients underwent tricuspid valve repair at our institution. Of those, 48 patients implanted with artificial neochordae were included in our study. The median age of the participants was 62 years (range, 4-77 yr) and 50% were women. Thirty patients (63%) were in New York Heart Association functional class III, and 11 (23%) were in class II. The cause of tricuspid regurgitation was functional in 33 patients (69%) and rheumatic in 15 (31%). In 46 patients, neochordae implantation was performed in addition to Kay annuloplasty (n=13) or ring annuloplasty (n=33). Forty-two patients were discharged from the hospital with absent or mild tricuspid regurgitation. The mean follow-up period was 44.3 ± 20.2 months. Follow-up echocardiograms revealed that tricuspid regurgitation was absent, minimal, or mild in 38 patients (80.8%), moderate in 7, and severe in 2. Our results indicate that the use of artificial neochordae implantation as an adjunct procedure to annuloplasty leads to effective and durable repair in comparison with conventional techniques for treating tricuspid regurgitation.

Citing Articles

Mini-loop technique for idiopathic isolated tricuspid valve prolapse: A case report.

Matsuno Y, Ikenaga S SAGE Open Med Case Rep. 2025; 13:2050313X251323297.

PMID: 39989712 PMC: 11846098. DOI: 10.1177/2050313X251323297.

Morphological diversity of the tricuspid posterior leaflet affects surgical complexity for control of tricuspid regurgitation.

Kawase T, Takahashi Y, Nishiya K, Kishimoto N, Yamane K, Sakon Y J Cardiothorac Surg. 2022; 17(1):18.

PMID: 35172869 PMC: 8848647. DOI: 10.1186/s13019-022-01762-5.

References

Ito T, Katogi T, Aeba R, Fujii H, Goto T, Kawada S . [Surgical repair of isolated congenital tricuspid regurgitation with artificial chordae--a case of two year-follow up]. Jpn J Thorac Cardiovasc Surg. 1999; 46(12):1334-8. DOI: 10.1007/BF03217925. View

Hachiro Y, Sugimoto S, Takagi N, Osawa H, Morishita K, Abe T . Native valve salvage for post-traumatic tricuspid regurgitation. J Heart Valve Dis. 2001; 10(2):276-8. View

Grinda J, Latremouille C, DAttellis N, Berrebi A, Chauvaud S, Carpentier A . Triple valve repair for young rheumatic patients. Eur J Cardiothorac Surg. 2002; 21(3):447-52. DOI: 10.1016/s1010-7940(01)01173-3. View

Matsuyama K, Matsumoto M, Sugita T, Nishizawa J, Tokuda Y, Matsuo T . Predictors of residual tricuspid regurgitation after mitral valve surgery. Ann Thorac Surg. 2003; 75(6):1826-8. DOI: 10.1016/s0003-4975(03)00028-6. View

KAY J, MASELLI-CAMPAGNA G, TSUJI K . SURGICAL TREATMENT OF TRICUSPID INSUFFICIENCY. Ann Surg. 1965; 162:53-8. PMC: 1476807. DOI: 10.1097/00000658-196507000-00009. View

McCarthy P, Bhudia S, Rajeswaran J, Hoercher K, Lytle B, Cosgrove D . Tricuspid valve repair: durability and risk factors for failure. J Thorac Cardiovasc Surg. 2004; 127(3):674-85. DOI: 10.1016/j.jtcvs.2003.11.019. View

De Bonis M, Lapenna E, La Canna G, Grimaldi A, Maisano F, Torracca L . A novel technique for correction of severe tricuspid valve regurgitation due to complex lesions. Eur J Cardiothorac Surg. 2004; 25(5):760-5. DOI: 10.1016/j.ejcts.2004.01.051. View

Messika-Zeitoun D, Thomson H, Bellamy M, Scott C, Tribouilloy C, Dearani J . Medical and surgical outcome of tricuspid regurgitation caused by flail leaflets. J Thorac Cardiovasc Surg. 2004; 128(2):296-302. DOI: 10.1016/j.jtcvs.2004.01.035. View

Dreyfus G, Corbi P, Chan K, Bahrami T . Secondary tricuspid regurgitation or dilatation: which should be the criteria for surgical repair?. Ann Thorac Surg. 2004; 79(1):127-32. DOI: 10.1016/j.athoracsur.2004.06.057. View

10.

Fukuda S, Song J, Gillinov A, McCarthy P, Daimon M, Kongsaerepong V . Tricuspid valve tethering predicts residual tricuspid regurgitation after tricuspid annuloplasty. Circulation. 2005; 111(8):975-9. DOI: 10.1161/01.CIR.0000156449.49998.51. View

11.

Aoyagi S, Tanaka K, Hara H, Kumate M, Oryoji A, Yasunaga H . Modified De Vega's annuloplasty for functional tricuspid regurgitation--early and late results. Kurume Med J. 1992; 39(1):23-32. DOI: 10.2739/kurumemedj.39.23. View

12.

Lai Y, Meng X, Bai T, Zhang C, Luo Y, Zhang Z . Edge-to-edge tricuspid valve repair: an adjuvant technique for residual tricuspid regurgitation. Ann Thorac Surg. 2006; 81(6):2179-82. DOI: 10.1016/j.athoracsur.2006.01.046. View

13.

Tang G, David T, Singh S, Maganti M, Armstrong S, Borger M . Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes. Circulation. 2006; 114(1 Suppl):I577-81. DOI: 10.1161/CIRCULATIONAHA.105.001263. View

14.

Kim H, Kim Y, Park J, Kim K, Kim K, Ahn H . Determinants of the severity of functional tricuspid regurgitation. Am J Cardiol. 2006; 98(2):236-42. DOI: 10.1016/j.amjcard.2006.01.082. View

15.

Ghanta R, Chen R, Narayanasamy N, McGurk S, Lipsitz S, Chen F . Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation: midterm results of 237 consecutive patients. J Thorac Cardiovasc Surg. 2007; 133(1):117-26. DOI: 10.1016/j.jtcvs.2006.08.068. View

16.

Han Q, Xu Z, Zhang B, Zou L, Hao J, Huang S . Primary triple valve surgery for advanced rheumatic heart disease in Mainland China: a single-center experience with 871 clinical cases. Eur J Cardiothorac Surg. 2007; 31(5):845-50. DOI: 10.1016/j.ejcts.2007.02.005. View

17.

Iscan Z, Vural K, Bahar I, Mavioglu L, Saritas A . What to expect after tricuspid valve replacement? Long-term results. Eur J Cardiothorac Surg. 2007; 32(2):296-300. DOI: 10.1016/j.ejcts.2007.05.003. View

18.

Dreyfus G, Raja S, Chan K . Tricuspid leaflet augmentation to address severe tethering in functional tricuspid regurgitation. Eur J Cardiothorac Surg. 2008; 34(4):908-10. DOI: 10.1016/j.ejcts.2008.07.006. View

19.

Raja S, Dreyfus G . Surgery for functional tricuspid regurgitation: current techniques, outcomes and emerging concepts. Expert Rev Cardiovasc Ther. 2008; 7(1):73-84. DOI: 10.1586/14779072.7.1.73. View

20.

Tang H, Xu Z, Zou L, Han L, Lu F, Lang X . Valve repair with autologous pericardium for organic lesions in rheumatic tricuspid valve disease. Ann Thorac Surg. 2009; 87(3):726-30. DOI: 10.1016/j.athoracsur.2008.12.005. View