Early experience treating tricuspid valve endocarditis with a novel extracellular matrix cylinder reconstruction

Marc W. Gerdisch*, W. Douglas Boyd, John L. Harlan, John B. Richardson, Joseph E. Flack, Brian A. Palafox, William E. Johnson, Benjamin Sun, Richard Lee, T. Sloane Guy, Gyu I. Gang, James Lewis Cox, Vivek Rao

*Corresponding author for this work

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Objective The short-term outcomes were evaluated in patients treated for tricuspid valve endocarditis using a novel extracellular matrix (ECM) cylinder reconstruction technique.

Results From November 2011 to October 2013, 12 surgeons performed 19 tricuspid valve cylinder reconstructions in 8 men and 10 women (age range, 19-53 years). Of the 19 patients, 11 had active and 5 had treated endocarditis. One case was robotic-assisted. No deaths occurred, and no new cases of heart block developed. The papillary attachments were disrupted intraoperatively in 1 patient and after 7 days in another; both were successfully revised. A third patient experienced recurrent disruption of the implant at 13 and 22 months and ultimately received a pericardial valve. Fungal infection occurred in 1 cylinder at 6 months; a second ECM cylinder was implanted. Follow-up data were available for 13 patients at 1 to 2 months, 8 at 6 months, and 3 at 12 and 18 months. Other than patients undergoing reoperation, all showed well-functioning tricuspid valves with no to mild regurgitation.

Conclusions Cylinder reconstruction with ECM could be a suitable technique for replacing the tricuspid valve while preserving annuloventricular continuity in patients with infective endocarditis not repairable by conventional techniques.

Original languageEnglish (US)
Pages (from-to)3042-3048
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume148
Issue number6
DOIs
StatePublished - Dec 1 2014

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Gerdisch, M. W., Boyd, W. D., Harlan, J. L., Richardson, J. B., Flack, J. E., Palafox, B. A., Johnson, W. E., Sun, B., Lee, R., Guy, T. S., Gang, G. I., Cox, J. L., & Rao, V. (2014). Early experience treating tricuspid valve endocarditis with a novel extracellular matrix cylinder reconstruction. Journal of Thoracic and Cardiovascular Surgery, 148(6), 3042-3048. https://doi.org/10.1016/j.jtcvs.2014.06.092