Liberal use of tricuspid valve detachment for transatrial ventricular septal defect closure

Ryo Aeba, Toshiyuki Katogi, Kenichi Hashizume, Kiyoshi Koizumi, Yoshimi Iino, Mitsuharu Mori, Ryohei Yozu

研究成果: Article

9 引用 (Scopus)

抄録

Background. Although temporary tricuspid valve detachment is useful for improved visualization of ventricular septal defect through right atriotomy, liberal use of this adjunct is not widely supported, mainly because of concerns about iatrogenic complications such as heart blocks and tricuspid valve dysfunction. The objective of this study was to determine whether liberal use of this adjunct can improve operative outcome. Methods. Between January1997 and March 2002, transatrial closure of isolated ventricular septal defect (conoventricular or canal type) was performed in 87 consecutive patients. Tricuspid valve detachment was used in 4 out of 44 patients (prudent-use group) and 19 out of 43 patients (liberal-use group) in the first and second half of this period, respectively (p = 0.0002). Patient demographics and use of other surgical and cardiopulmonary bypass techniques remained virtually unchanged during this period. Results. In the prudent-use group, there was one operative death with prolonged bypass time and one residual defect that required reoperation; neither of these patients underwent tricuspid valve detachment. All other patients (both groups) were free from mortality and clinically significant complications, including heart block, tricuspid regurgitation, and residual defect. The liberal-use group had shorter cardiopulmonary bypass time than the prudent-use group (59 ± 14 vs 67 ± 22 minutes, p = 0.037). Conclusions. Tricuspid valve detachment should be used liberally for moderate- or even low-difficulty exposure of ventricular septal defect, regardless of patient background, because it is a safe and effective adjunct that can improve speed, programmability, reproducibility, and reliability.

元の言語English
ページ(範囲)1073-1077
ページ数5
ジャーナルAnnals of Thoracic Surgery
76
発行部数4
DOI
出版物ステータスPublished - 2003 10 1

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Tricuspid Valve
Ventricular Heart Septal Defects
Heart Block
Cardiopulmonary Bypass
Tricuspid Valve Insufficiency
Heart Valves
Reoperation
Demography
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

これを引用

Aeba, R., Katogi, T., Hashizume, K., Koizumi, K., Iino, Y., Mori, M., & Yozu, R. (2003). Liberal use of tricuspid valve detachment for transatrial ventricular septal defect closure. Annals of Thoracic Surgery, 76(4), 1073-1077. https://doi.org/10.1016/S0003-4975(03)00723-9

Liberal use of tricuspid valve detachment for transatrial ventricular septal defect closure. / Aeba, Ryo; Katogi, Toshiyuki; Hashizume, Kenichi; Koizumi, Kiyoshi; Iino, Yoshimi; Mori, Mitsuharu; Yozu, Ryohei.

:: Annals of Thoracic Surgery, 巻 76, 番号 4, 01.10.2003, p. 1073-1077.

研究成果: Article

Aeba, R, Katogi, T, Hashizume, K, Koizumi, K, Iino, Y, Mori, M & Yozu, R 2003, 'Liberal use of tricuspid valve detachment for transatrial ventricular septal defect closure', Annals of Thoracic Surgery, 巻. 76, 番号 4, pp. 1073-1077. https://doi.org/10.1016/S0003-4975(03)00723-9
Aeba, Ryo ; Katogi, Toshiyuki ; Hashizume, Kenichi ; Koizumi, Kiyoshi ; Iino, Yoshimi ; Mori, Mitsuharu ; Yozu, Ryohei. / Liberal use of tricuspid valve detachment for transatrial ventricular septal defect closure. :: Annals of Thoracic Surgery. 2003 ; 巻 76, 番号 4. pp. 1073-1077.
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AU - Aeba, Ryo

AU - Katogi, Toshiyuki

AU - Hashizume, Kenichi

AU - Koizumi, Kiyoshi

AU - Iino, Yoshimi

AU - Mori, Mitsuharu

AU - Yozu, Ryohei

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N2 - Background. Although temporary tricuspid valve detachment is useful for improved visualization of ventricular septal defect through right atriotomy, liberal use of this adjunct is not widely supported, mainly because of concerns about iatrogenic complications such as heart blocks and tricuspid valve dysfunction. The objective of this study was to determine whether liberal use of this adjunct can improve operative outcome. Methods. Between January1997 and March 2002, transatrial closure of isolated ventricular septal defect (conoventricular or canal type) was performed in 87 consecutive patients. Tricuspid valve detachment was used in 4 out of 44 patients (prudent-use group) and 19 out of 43 patients (liberal-use group) in the first and second half of this period, respectively (p = 0.0002). Patient demographics and use of other surgical and cardiopulmonary bypass techniques remained virtually unchanged during this period. Results. In the prudent-use group, there was one operative death with prolonged bypass time and one residual defect that required reoperation; neither of these patients underwent tricuspid valve detachment. All other patients (both groups) were free from mortality and clinically significant complications, including heart block, tricuspid regurgitation, and residual defect. The liberal-use group had shorter cardiopulmonary bypass time than the prudent-use group (59 ± 14 vs 67 ± 22 minutes, p = 0.037). Conclusions. Tricuspid valve detachment should be used liberally for moderate- or even low-difficulty exposure of ventricular septal defect, regardless of patient background, because it is a safe and effective adjunct that can improve speed, programmability, reproducibility, and reliability.

AB - Background. Although temporary tricuspid valve detachment is useful for improved visualization of ventricular septal defect through right atriotomy, liberal use of this adjunct is not widely supported, mainly because of concerns about iatrogenic complications such as heart blocks and tricuspid valve dysfunction. The objective of this study was to determine whether liberal use of this adjunct can improve operative outcome. Methods. Between January1997 and March 2002, transatrial closure of isolated ventricular septal defect (conoventricular or canal type) was performed in 87 consecutive patients. Tricuspid valve detachment was used in 4 out of 44 patients (prudent-use group) and 19 out of 43 patients (liberal-use group) in the first and second half of this period, respectively (p = 0.0002). Patient demographics and use of other surgical and cardiopulmonary bypass techniques remained virtually unchanged during this period. Results. In the prudent-use group, there was one operative death with prolonged bypass time and one residual defect that required reoperation; neither of these patients underwent tricuspid valve detachment. All other patients (both groups) were free from mortality and clinically significant complications, including heart block, tricuspid regurgitation, and residual defect. The liberal-use group had shorter cardiopulmonary bypass time than the prudent-use group (59 ± 14 vs 67 ± 22 minutes, p = 0.037). Conclusions. Tricuspid valve detachment should be used liberally for moderate- or even low-difficulty exposure of ventricular septal defect, regardless of patient background, because it is a safe and effective adjunct that can improve speed, programmability, reproducibility, and reliability.

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