• Journal of Chest Surgery
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• 제56권5호
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• pp.304-310
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• 2023

Background: The late progression of tricuspid regurgitation (TR) after mitral valve surgery is well known. However, few reports have described the progression of TR after aortic valve surgery. We investigated the incidence of and risk factors for the development of significant TR after isolated aortic valve replacement (AVR). Methods: This study analyzed patients with less than moderate TR who underwent isolated AVR at Seoul National University Hospital from January 1990 to December 2018. Significant TR was defined as moderate or higher. Echocardiographic follow-up was performed in all patients. The Fine-Gray model was used to identify clinical risk factors for the development of significant TR. Results: In total, 583 patients (61.7±14.2 years old) were included. Operative mortality occurred in 9 patients (1.5%), and the overall survival rates at 10, 20, and 25 years were 91.1%, 83.2%, and 78.9%, respectively. Sixteen patients (2.7%) developed significant TR during the follow-up period (13 moderate; 3 severe). The cumulative incidence of significant TR at 10, 20, and 25 years was 0.77%, 3.83%, and 6.42%, respectively. No patients underwent reoperation or reintervention of the tricuspid valve. Hemodialysis or peritoneal dialysis for chronic kidney disease (hazard ratio [HR], 5.188; 95% confidence interval [CI], 1.154-23.322) and preoperative mild TR (HR, 5.919; 95% CI, 2.059-17.017) were associated with the development of significant TR in the multivariable analysis. Conclusion: TR progression after isolated AVR in patients with less than moderate TR is rare. Preoperative mild TR and hemodialysis or peritoneal dialysis for chronic kidney disease were significant risk factors for the development of TR.

• Journal of Chest Surgery
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• 제11권4호
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• pp.428-432
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• 1978

Between Jan. and Oct. 1978, mitral valve Replacement had been performed on eight patients using porcine aortic valve mounted on flexible polypropylene or Egyloil wire and Dacron covered stent. Mitral valve replacement was performed on five, mitral valve replacement with tricuspid valve replacement on two, and mitral valve replacement with tricuspid valve annuloplasty on 1 patient using five Carpentier and five Hancock Xenograft. Overall operative deaths were 2 cases. All other 6 cases did well after surgery and improved. No systemic thromboembolism occurred without anticoagulant-No valve failure took place. The results are satisfactory.

• Journal of Chest Surgery
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• 제26권3호
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• pp.196-203
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• 1993

Fourty-five cases of operation were performed for the correction of tricuspid regurgitation [TR] in Pusan National University Hospital between 1982 and 1991.The mean age of the patients was 32.6 years and female was dominant[M:F=1:2.2].Isolated tricuspid regurgitation was rare and 43 patients underwent concomitant other valvular operation including mitral valve replacement. Functional cause was in 39 cases and organic lesions were found in 6 cases. Operative methods were Kay annuloplasty[29], De Vega annuloplasty[12], and tricuspid valve replacement[4]. Ring annuloplasty was not performed. Operative mortality rate was 11.1%[5/45] and late mortality rate was 6.7%[2/30]. The tricuspid valve surgery itself was not a serious risk factor for hospital death and no heart block nor thrombosis was complicated. By echocardiogram early[within 30 days] and late [mean:4.9years] changes of postoperative TR were evaluated. De Vega annuloplasty seemed to bring better late result than Kay annuloplasty[p<0.05]. In four patients with late severe TR,previously replaced tissue valve degeneration[2], pulmonary hypertension[1] and rheumatic TR[1] were the possible causes. This experience suggests that De Vega annuloplasty can be a reliable method in the majority of patients with moderate-to-severe functional TR.

• Journal of Chest Surgery
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• 제47권4호
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• pp.398-401
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• 2014

Severe tricuspid regurgitation resulting from a flail leaflet is a rare cause of neonatal cyanosis. We report a neonate with profound cyanosis and severe tricuspid regurgitation caused by a rupture of the papillary muscle supporting the anterior leaflet, without other structural heart defects. Ductal patency could not be established. The repair of the tricuspid valve was performed after initial stabilization by using extracorporeal membrane oxygenation.

• Journal of Chest Surgery
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• 제43권6호
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• pp.739-742
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• 2010

투석중인 40세의 만성 신부전 환자가 우측 쇄골하정맥 협착증으로 지역병원에서 2개의 스텐트를 삽입하였다. 경과 관찰 중 한 개의 스텐트가 우심실로 이동하면서 삼첨판막 폐쇄부전이 발생하였다. 경피적으로 스텐트 제거를 시도하였으나 실패하여 개흉 성장수술로 제거하면서 삼첨판막 성형술을 시행하여 좋은 결과를 보였기에 보고하고자 한다.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.264-268
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• 2020

A 55-year-old man underwent emergent sternotomy due to cardiac tamponade occurring just after an accidental fall from a 10-m height. Tricuspid valve regurgitation was found on echocardiography while he was on mechanical ventilation after the operation. The patient was weaned successfully from mechanical ventilation after tricuspid valve repair under cardiopulmonary bypass. Traumatic tricuspid valve regurgitation is a rare blunt chest injury and its symptoms occur late. Tricuspid regurgitation should be considered as a reason for failure to wean from mechanical ventilation after blunt cardiac trauma.

• Journal of Chest Surgery
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• 제32권12호
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• pp.1119-1122
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• 1999

Native valve endocarditis (NVE) without preexisting structural valve or congenital cardiac malformation especially in pediatric group is rare. A case of isolated tricuspid valve endocarditis in a 7-year-old child without any cardiac malformation is described. This child had suffered from fever and productive cough for 3 weeks. Blood culture grew Staphylococcus aureus. Fever was not controlled even with proper antibiotic treatment. Transthoracic echocardiogram and lung perfusion scan revealed a large vegetation on the tricuspid valve with multiple embolism Surgical procedures included vegetectomy partial cusps resection and pericardial patch valvuloplasty. Th patient was in NYHA class I during follow up.

• Journal of Chest Surgery
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• 제36권10호
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• pp.776-779
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• 2003

기침과 고열을 주소로 8세 남아가 전원되었으며, 과거력상 출생시 작은 크기의 심실 중격결손이 있었다. 심장 초음파 검사상 삼첨판에 10${\times}$6mm 크기의 우종이 있었고 심실중격결손 및 중등도의 삼천판 폐쇄부전이 발견되었다. 혈액 균배양 검사에서는 메티씰린 저항성 황색포도구균이 나왔다. 충분한 항생제 치료에도 불구하고 열이 조절되지 않았으며 폐경색이 진행되었다. 정중 흉골 절개하에 혈전제거술 및 우측폐하엽 절제술을 먼저 시행하였으며, 체외순환 하에 우종제거술, 삼첨판 재건술 및 심실중격결손 폐쇄술을 시행하였다.

• Journal of Chest Surgery
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• 제14권3호
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• pp.247-253
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• 1981

A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

• Journal of Chest Surgery
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• 제13권4호
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• pp.405-413
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• 1980

A total of 63 patients [42 males and 21 females] underwent multiple valve replacement with artificial valves between January 1975 and August 1980 at Seoul National University Hospital. There were 38 patients with aortic and mitral valve replacement, 22 with mitral and tricuspid, and 3 with aortic, mitral and tricuspid valve replacement. The valve lesions varied from trivial to severe and most aortic and mitral valves had mixed stenosis and insufficiency, while tricuspid valves had only insufficiency. The patients were severely symptomatic in majority of the cases, and belonged to the Classes III and IV [III:45, IV:16] of the NYHA functional criteria. Hemodynamic studies were performed on all the patients. The mean pulmonary wedge pressure was remarkably increased to 19.8 mmHg in aortic and mitral valve lesions and 18.0 mmHg in mitral and tricuspid valve lesions. The mean pulmonary arterial pressure was also increased, while the cardiac index was reduced. In 1977, the average perfusion time was 245.5 minutes for aortic and mitral valve replacement and 181.6 minutes for mitral and tricuspid valve replacement. It has progressively declined to 169.2 minutes for aortic and mitral valve replacement and 123 minutes for mitral and tricuspid valve replacement in 1980. The average period of aortic occlusion also declined after the use of cardioplegic solution. Twenty deaths occurred among the 63 patients operated upon, an overall mortality rate of 30.8%. The operative mortality has declined with successive year from a level of 66.7% before 1977 to 21.1% in 1980. Fourteen patients suffered from a list of postoperative complications, which eventually resolved with adequate treatment. All the survivors were enjoying the levels of daily life activities greater than those existing before the operation.