Abstract
Background Concomitant use of tricuspid valve (TV) surgery and minimally invasive mitral valve
(MV) repair is debatable due to a prolonged time of surgery with presumably elevated
operative risk. Herein, we examined cardiopulmonary bypass times and 30-day mortality
in patients who underwent MV repair with and without concomitant TV surgery.
Methods We retrospectively evaluated 3,962 patients with MV regurgitation who underwent minimally
invasive MV repair without (n = 3,463; MVr group) and with (n = 499; MVr + TVr group) concomitant TV surgery between 1999 and 2014. Preoperative
parameters between the groups were significantly different; therefore, propensity
score matching was performed.
Results Mean cardiopulmonary bypass time for all patients was 125.5 ± 55.8 minutes in MVr
and 162.0 ± 58.0 minutes in MVr + TVr (p < 0.001). Overall 30-day mortality was significantly different between these groups
(4.8 vs. 2.1%; p < 0.001); however, after adjustment, there was no significant difference (3.3 vs.
1.2%; p = 0.07). Backward logistic regression revealed that cardiopulmonary bypass time was
not a significant predictor for early mortality within the MVr + TVr cohort.
Conclusion Concomitant TV repair using prosthetic rings through a minimally invasive approach
is safe and does not lead to elevated early mortality in our patient cohort. Therefore,
prolonged cardiopulmonary bypass time should not be the sole reason to rule out MV
repair with concomitant TV repair and to prefer the use of suture techniques, which
saves only a few minutes compared with prosthetic ring implantation.
Keyword
mitral valve surgery - tricuspid valve - minimally invasive surgery
