Kardiochirurgia i Torakochirurgia Polska

Abstract

1/2023 vol. 20
Original paper

Infective endocarditis of the tricuspid valve. Surgical treatment with pericardial cylinder implantation

  1. Department of Cardiac Surgery, University Clinical Hospital, Bialystok, Poland
  2. Department of Invasive Cardiology, University Clinical Hospital, Bialystok, Poland
Kardiochirurgia i Torakochirurgia Polska 2023; 20 (1): 18-23
Online publish date: 2023/04/03
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Introduction

Infective endocarditis (IE) on the tricuspid valve usually requires the complete resection of the infected tissue and implantation of a valve prosthesis.

Aim

We assumed that total elimination of artificial material and implantation of the entirely patient-derived biological material would reduce the recurrence of IE.

Material and methods

The group consisted of 7 consecutive patients who underwent implantation of a cylindrical valve created from the patient’s own pericardium in the tricuspid orifice. There were only men aged 43 to 73 years. Isolated tricuspid valve reimplantation with a pericardial cylinder was performed in 2 patients. Five (71%) patients needed additional procedures. The postoperative follow-up ranged from 2 to 32 months (median: 17 months).

Results

In patients who underwent isolated tissue cylinder implantation, the average extracorporeal circulation (ECC) time was 77.5 minutes and aortic cross-clamp time was 58 minutes. In cases where additional procedures were performed the ECC and X-clamp times were 197.4 and 156.2 minutes, respectively. The function of the implanted valve was examined after weaning from the ECC by transesophageal echocardiogram, followed by transthoracic echocardiogram on day 5–7 after surgery revealed normal function of the prosthesis in all patients. There was no operative mortality. Two late deaths were observed.

Conclusions

In the follow-up period none of the patients had a recurrence of IE within the pericardial cylinder. Degeneration with subsequent stenosis of the pericardial cylinder occurred in 3 patients. One patient was reoperated on; one had a transcatheter valve-in-valve cylinder implantation.

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