Abstract
Background
Video-assisted minimally invasive (MIC) tricuspid valve repair or replacement through
right minithoracotomy offers a less invasive option for the treatment of tricuspid
valve insufficiency compared with conventional sternotomy approach.
Methods
We present our postoperative results regarding the two different surgical approaches.
Results
From 2017 to 2021, 180 patients underwent isolated or combined tricuspid valve procedures
in our heart center, either through median sternotomy (n = 152, group 1) or via MIC approach (n = 28, group 2). Mean age was 68 ± 11 years in group 1 and 69 ± 11 years in group
2. A propensity matching analysis was performed comparing 21 patients from each group.
The majority of the patients in both groups received tricuspid valve repair (90% in
unmatched group 1 and 79% in unmatched group 2). Tricuspid valve replacement was performed
in 10% of group 1 versus 21% of group 2. The 30-day mortality was higher in matched
group 1 patients (14%) in comparison to matched group 2 patients (5%; odds ratio [OR] = 3.00;
[0.31, 28.84]; p = 0.341). Mean required packed red blood cells was 9.43 ± 11.79 units in group 1,
respectively, 3.57 ± 4.75 units in group 2 (OR = 1.12; [0.98, 1.29]; p = 0.099). Postoperative echocardiography revealed excellent tricuspid valve function
in both matched groups.
Conclusion
Video-assisted minimally invasive (MIC) tricuspid valve repair or replacement through
right mini-thoracotomy is a good alternative to sternotomy approach. Our postoperative
results demonstrate that MIC approach is safe and feasible.
Keywords
minimally invasive - video-assisted - right minithoracotomy - tricuspid valve repair
- tricuspid valve replacement
