Skip to main content
SpringerLink
Log in

Short- and Midterm outcomes of modified robotic tricuspid annuloplasty for secondary tricuspid regurgitation

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background

Despite the growing popularity of robotically assisted mitral repair, robotically assisted tricuspid repair has not been widely adopted. We assessed the safety and feasibility of robotic tricuspid annuloplasty with continuous sutures for tricuspid regurgitation (TR).

Methods and results

We studied consecutive 68 patients (median age, 74 years) with secondary TR who underwent tricuspid annuloplasty using continuous sutures with (n = 61) and without mitral valve repair (n = 7) from 2018 to 2021. Robotic tricuspid annuloplasty consists of continuous sutures with flexible prosthetic band to the tricuspid annulus using two V-Loc barbed sutures (Medtronic Inc., Minneapolis, MN). Concomitant maze procedure was performed in 45 (66%) patients. Robotic tricuspid annuloplasty with continuous sutures was successfully performed. There was no in-hospital or 30-day mortality; 65 patients (96%) did not experience major surgery-related complications. Preoperatively, the TR grade was mild in 20 (29%) patients and mildly higher in 48 (71%). Postoperatively, the TR severity significantly improved, with TR grade mildly higher in 9% at hospital discharge and 7% at 1-year follow-up (p < 0.001). The 1-year and 2-year freedom rates from heart failure were 98% and 95%, respectively.

Conclusions

Robotic tricuspid annuloplasty with continuous sutures is safe and feasible alone or concomitant with mitral valve repair. It offered sustained improvement in TR severity and might prevent heart failure readmission.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Izumi C, Miyake M, Takahashi S, Matsutani H, Hashiwada S, Kuwano K, et al. Progression of isolated tricuspid regurgitation late after left-sided valve surgery: clinical features and mechanisms. Circ J. 2011;75:2902–7.

    Article  PubMed  Google Scholar 

  2. Lee H, Sung K, Kim WS, Lee YT, Park SJ, Carriere KC, et al. Clinical and hemodynamic influences of prophylactic tricuspid annuloplasty in mechanical mitral valve replacement. J Thorac Cardiovasc Surg. 2016;151:788–95.

    Article  PubMed  Google Scholar 

  3. Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP 3rd, Gentile F, et al. 2020 ACC/AHA Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;143:e72–227.

    PubMed  Google Scholar 

  4. Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease: developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg. 2021;60:727–800.

    Article  PubMed  Google Scholar 

  5. Lewis CT, Stephens RL, Tyndal CM, Cline JL. Concomitant robotic mitral and tricuspid valve repair: technique and early experience. Ann Thorac Surg. 2014;97:782–7.

    Article  PubMed  Google Scholar 

  6. Kawamoto N, Fukushima S, Shimahara Y, Yamasaki T, Matsumoto Y, Yamashita K, et al. Benefit and risk of minimally invasive mitral valve repair for type II dysfunction—propensity score matched comparison. Circ J. 2018;83:224–31.

    Article  PubMed  Google Scholar 

  7. Toya T, Fujita T, Fukushima S, Shimahara Y, Kume Y, Yamashita K, et al. Efficacy of regional saturation of oxygen monitor using near-infrared spectroscopy for lower limb ischemia during minimally invasive cardiac surgery. J Artif Organs. 2018;21:420–6.

    Article  PubMed  Google Scholar 

  8. Kakuta T, Fukushima S, Shimahara Y, Yajima S, Tadokoro N, Minami K, et al. Early results of robotically assisted mitral valve repair in a single institution: report of the first 100 cases. Gen Thorac Cardiovasc Surg. 2020;68:1079–85.

    Article  PubMed  Google Scholar 

  9. Watanabe G, Ishikawa N. Use of barbed suture in robot-assisted mitral valvuloplasty. Ann Thorac Surg. 2015;99:343–5.

    Article  PubMed  Google Scholar 

  10. Dreyfus GD, Corbi PJ, Chan KM, Bahrami T. Secondary tricuspid regurgitation of dilatation: which should be the criteria for surgical repair? Ann Thorac Surg. 2005;79:127–32.

    Article  PubMed  Google Scholar 

  11. Carpentier A, Deloche A, Hanania G, Forman J, Sellier P, Piwnica A, et al. Surgical management of acquired tricuspid valve disease. J Thorac Cardiovasc Surg. 1974;67:53–65.

    Article  CAS  PubMed  Google Scholar 

  12. Sakon Y, Murakami T, Fujii H, Takahashi Y, Morisaki A, Yamane K, et al. New insight into tricuspid valve anatomy from 100 hearts to reappraise annuloplasty methodology. Gen Thorac Cardiovasc Surg. 2019;67:758–64.

    Article  PubMed  Google Scholar 

  13. Hata H, Fujita T, Miura S, Shimahara Y, Kume Y, Matsumoto Y, et al. Long- term outcomes of suture vs ring tricuspid annuloplasty for functional tricuspid regurgitation. Circ J. 2017;81:1432–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank Gina F from Enago (www.enago.jp) for the English language review.

Funding

This research did not receive any specific graft from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Departments of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

    Kazuki Noda, Satsuki Fukushima, Takashi Kakuta, Satoshi Kainuma, Naonori Kawamoto, Naoki Tadokoro, Ayumi Ikuta & Tomoyuki Fujita

Authors
  1. Kazuki Noda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Satsuki Fukushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takashi Kakuta
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Satoshi Kainuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Naonori Kawamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naoki Tadokoro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ayumi Ikuta
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tomoyuki Fujita
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Writing: KN. Critical review and revision: all authors. Final approval of the article: all authors. Accountability for all aspects of the work: all authors.

Corresponding author

Correspondence to Satoshi Kainuma.

Ethics declarations

Conflict of interest

The authors declare that there are no conflicts of interest.

IRB information

Reporting was approved by NCVC institutional review board. Reference number is M30-026-8. https://www.ncvc.go.jp/hospital/wp-content/uploads/sites/2/M30-026-8_1.pdf

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Noda, K., Fukushima, S., Kakuta, T. et al. Short- and Midterm outcomes of modified robotic tricuspid annuloplasty for secondary tricuspid regurgitation. Gen Thorac Cardiovasc Surg 71, 692–699 (2023). https://doi.org/10.1007/s11748-023-01950-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-023-01950-7

Keywords

Search

Navigation