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

doi:10.1016/j.jtcvs.2014.06.092

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

Surgery, Cardiac Surgery Division

Research output: Contribution to journal › Article › peer-review

46 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 language	English (US)
Pages (from-to)	3042-3048
Number of pages	7
Journal	Journal of Thoracic and Cardiovascular Surgery
Volume	148
Issue number	6
DOIs	https://doi.org/10.1016/j.jtcvs.2014.06.092
State	Published - Dec 1 2014

Funding

The authors thank Molly Miller for coordinating data collection. Jeanne McAdara-Berkowitz, PhD, provided professional assistance with manuscript preparation, which was funded through an unrestricted grant from CorMatrix Cardiovascular . The authors maintained freedom of investigation and control over the study and manuscript.

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine

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10.1016/j.jtcvs.2014.06.092

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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

@article{a26ce0976f034f5faeef5cc84779a904,

title = "Early experience treating tricuspid valve endocarditis with a novel extracellular matrix cylinder reconstruction",

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.",

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

note = "Funding Information: The authors thank Molly Miller for coordinating data collection. Jeanne McAdara-Berkowitz, PhD, provided professional assistance with manuscript preparation, which was funded through an unrestricted grant from CorMatrix Cardiovascular . The authors maintained freedom of investigation and control over the study and manuscript. ",

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doi = "10.1016/j.jtcvs.2014.06.092",

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Gerdisch, MW, Boyd, WD, Harlan, JL, Richardson, JB, Flack, JE, Palafox, BA, Johnson, WE, Sun, B, Lee, R, Guy, TS, Gang, GI, Cox, JL & Rao, V 2014, 'Early experience treating tricuspid valve endocarditis with a novel extracellular matrix cylinder reconstruction', Journal of Thoracic and Cardiovascular Surgery, vol. 148, no. 6, pp. 3042-3048. https://doi.org/10.1016/j.jtcvs.2014.06.092

TY - JOUR

T1 - Early experience treating tricuspid valve endocarditis with a novel extracellular matrix cylinder reconstruction

AU - Gerdisch, Marc W.

AU - Boyd, W. Douglas

AU - Harlan, John L.

AU - Richardson, John B.

AU - Flack, Joseph E.

AU - Palafox, Brian A.

AU - Johnson, William E.

AU - Sun, Benjamin

AU - Lee, Richard

AU - Guy, T. Sloane

AU - Gang, Gyu I.

AU - Cox, James Lewis

AU - Rao, Vivek

N1 - Funding Information: The authors thank Molly Miller for coordinating data collection. Jeanne McAdara-Berkowitz, PhD, provided professional assistance with manuscript preparation, which was funded through an unrestricted grant from CorMatrix Cardiovascular . The authors maintained freedom of investigation and control over the study and manuscript.

PY - 2014/12/1

Y1 - 2014/12/1

N2 - 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.

AB - 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.

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

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ASJC Scopus subject areas

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