Abstract
Background Minimally invasive cardiac surgery via right lateral minithoracotomy is a well-described
approach. However, reports on isolated tricuspid valve surgery (TVS) in this technique
are rare. Therefore, we like to give a contribution by reporting our experience.
Methods We retrospectively reviewed 25 tricuspid valve operations via right lateral minithoracotomy
with femoral cannulation between August 2009 and September 2013 (18 repairs, 7 replacements,
and 72% repair rate). Three patients (12%) presented for a re-do operation, and nine
patients (36%) suffered from active endocarditis at admission. All patients underwent
TVS as single valve procedure. Ten patients received additional procedures such as
removal of infected leads, resection of atrial tumors, or closure of atrial septal
defects. An annuloplasty ring was inserted in 12 cases. We investigated the short-term
morbidity and mortality with regard to the surgical procedure.
Results Repair rate was 72%. Thirty-day and 1-year mortality were 4 and 20%, respectively.
The only patient with early mortality received the surgical procedure on the tricuspid
valve as fourth cardiac-related surgery and postoperative mortality was due to intracranial
air embolism. Perioperative morbidity included reoperation for bleeding (8%) and stroke
(4%). No disturbance of wound healing occurred. Durations of intensive care unit stay
and hospital stay were 2.3 ± 2.4 and 17.4 ± 13.1 days, respectively. Endocarditis-caused
surgery did not reveal any significant difference in the intra- or perioperative course
compared with other indications.
Conclusion Minimally invasive TVS via right lateral minithoracotomy is feasible with good results.
Even in a cohort of patients suffering from elevated rate of active endocarditis,
a high repair rate can be achieved.
Keywords
minimally invasive approach - minithoracotomy - tricuspid valve surgery - endocarditis
