Clinical outcome of tricuspid valve replacement in children aged no more than 14 years_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

DUN Yaojun ,  SUN Haining , YAN Jun , HUA Zhongdong , LI Shoujun

Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China;

Corresponding author：

SUN Haining, Email: shnjn@126.com

Keywords：

Tricuspid valve replacement; children; Ebstein anomaly; treatment; surgery

DOI：

10.7507/1007-4848.202003030

Video：

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Objective To summarize the clinical characteristics and outcome of tricuspid valve replacement (TVR) in children aged no more than 14 years, and to discuss the selection of prosthesis.Methods From September 2002 to August 2019, 14 patients aged no more than 14 years who received TVR were included in our study. There were 9 males and 5 females, with a mean age of 9.8±4.3 years.Results Mechanical prosthesis was implanted in 8 patients, and bioprosthesis in 6 patients. The mean cardiopulmonary time and aortic-clamp time was 170.3±109.8 min and 95.1±63.1 min, respectively. The mortality within 30 days after surgery was 21.4% (3/14), and all 3 patients died of severe low cardiac output syndrome. Eleven patients were followed up for 34-199 (100.1±57.4) months. During the follow-up, mechanical prosthesis dysfunction occurred in 3 patients, 2 of whom received secondary TVR. One patient died during the follow-up.Conclusion The bioprosthesis is the first choice for TVR in children. Some long-term complications may occur after TVR, and close follow-up and timely intervention are needed.

Citation： DUN Yaojun, SUN Haining, YAN Jun, HUA Zhongdong, LI Shoujun. Clinical outcome of tricuspid valve replacement in children aged no more than 14 years. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(11): 1298-1302. doi: 10.7507/1007-4848.202003030 Copy

1.	Husain SA, Brown JW. When reconstruction fails or is not feasible: valve replacement options in the pediatric population. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2007, 10(1): 117-124.
2.	Bartlett HL, Atkins DL, Burns TL, et al. Early outcomes of tricuspid valve replacement in young children. Circulation, 2007, 115(3): 319-325.
3.	Kalangos A, Sierra J, Beghetti M, et al. Tricuspid valve replacement with a mitral homograft in children with rheumatic tricuspid valvulopathy. J Thorac Cardiovasc Surg, 2004, 127(6): 1682-1687.
4.	甘辉立, 张健群, 葛永强, 等. 三尖瓣置换治疗重症儿童 Ebstein 心脏畸形. 实用儿科临床杂志, 2008, 23(3): 229-231.
5.	Wang J, Liang YW, Hayashi J. Selective annuloplasty for tricuspid regurgitation in children. Ann Thorac Surg, 2005, 79(3): 937-941.
6.	Boston US, Dearani JA, O'Leary PW, et al. Tricuspid valve repair for Ebstein's anomaly in young children: A 30-year experience. Ann Thorac Surg, 2006, 81(2): 690-695.
7.	Dawood MY, Cheema FH, Ghoreishi M, et al. Contemporary outcomes of operations for tricuspid valve infective endocarditis. Ann Thorac Surg, 2015, 99(2): 539-546.
8.	Kiziltan HT, Theodoro DA, Warnes CA, et al. Late results of bioprosthetic tricuspid valve replacement in Ebstein's anomaly. Ann Thorac Surg, 1998, 66(5): 1539-1545.
9.	迟立群, 孔晴宇, 肖巍, 等. 173 例三尖瓣置换术长期随访结果分析. 心肺血管病杂志, 2015, 34(5): 380-383.
10.	陈澍, 孙宗全, 董念国, 等. 儿童心脏瓣膜置换术的近远期疗效分析. 华中科技大学学报 (医学版), 2015, 44(5): 545-548.
11.	董然, 陈宝田, 刘韬帅, 等. 12 岁以下儿童心脏瓣膜置换术的临床特点及中远期随访. 实用儿科临床杂志, 2010, 25(13): 1024-1026.
12.	Eble BK, Fiser WP, Simpson P, et al. Mitral valve replacement in children: predictors of long-term outcome. Ann Thorac Surg, 2003, 76(3): 853-859.
13.	Williams DB, Danielson GK, McGoon DC, et al. Porcine heterograft valve replacement in children. J Thorac Cardiovasc Surg, 1982, 84(3): 446-450.
14.	Guerra F, Bortolotti U, Thiene G, et al. Long-term performance of the Hancock porcine bioprosthesis in the tricuspid position. A review of forty-five patients with fourteen-year follow-up. J Thorac Cardiovasc Surg, 1990, 99(5): 838-845.
15.	Brown ML, Dearani JA, Danielson GK, et al. Comparison of the outcome of porcine bioprosthetic versus mechanical prosthetic replacement of the tricuspid valve in the Ebstein anomaly. Am J Cardiol, 2009, 103(4): 555-561.
16.	Said SM, Burkhart HM, Schaff HV, et al. When should a mechanical tricuspid valve replacement be considered? J Thorac Cardiovasc Surg, 2014, 148(2): 603-608.
17.	Mohamed KS. Tricuspid valve replacement in infants and children with exclusively autologous tissue. World J Pediatr Congenit Heart Surg, 2017, 8(1): 88-91.
18.	Hermsen JL, Permut LC, McQuinn TC, et al. Tricuspid valve replacement with a melody stented bovine jugular vein conduit. Ann Thorac Surg, 2014, 98(5): 1826-1827.
19.	Fernandez-Doblas J, Perez-Andreu J, Betrian P, et al. Pediatric tricuspid valve replacement with transcatheter bioprosthetic valve: an alternative option in high-risk patients. Semin Thorac Cardiovasc Surg, 2019. [Epub ahead of print].
20.	Topilsky Y, Khanna AD, Oh JK, et al. Preoperative factors associated with adverse outcome after tricuspid valve replacement. Circulation, 2011, 123(18): 1929-1939.

1. Husain SA, Brown JW. When reconstruction fails or is not feasible: valve replacement options in the pediatric population. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2007, 10(1): 117-124.
2. Bartlett HL, Atkins DL, Burns TL, et al. Early outcomes of tricuspid valve replacement in young children. Circulation, 2007, 115(3): 319-325.
3. Kalangos A, Sierra J, Beghetti M, et al. Tricuspid valve replacement with a mitral homograft in children with rheumatic tricuspid valvulopathy. J Thorac Cardiovasc Surg, 2004, 127(6): 1682-1687.
4. 甘辉立, 张健群, 葛永强, 等. 三尖瓣置换治疗重症儿童 Ebstein 心脏畸形. 实用儿科临床杂志, 2008, 23(3): 229-231.
5. Wang J, Liang YW, Hayashi J. Selective annuloplasty for tricuspid regurgitation in children. Ann Thorac Surg, 2005, 79(3): 937-941.
6. Boston US, Dearani JA, O'Leary PW, et al. Tricuspid valve repair for Ebstein's anomaly in young children: A 30-year experience. Ann Thorac Surg, 2006, 81(2): 690-695.
7. Dawood MY, Cheema FH, Ghoreishi M, et al. Contemporary outcomes of operations for tricuspid valve infective endocarditis. Ann Thorac Surg, 2015, 99(2): 539-546.
8. Kiziltan HT, Theodoro DA, Warnes CA, et al. Late results of bioprosthetic tricuspid valve replacement in Ebstein's anomaly. Ann Thorac Surg, 1998, 66(5): 1539-1545.
9. 迟立群, 孔晴宇, 肖巍, 等. 173 例三尖瓣置换术长期随访结果分析. 心肺血管病杂志, 2015, 34(5): 380-383.
10. 陈澍, 孙宗全, 董念国, 等. 儿童心脏瓣膜置换术的近远期疗效分析. 华中科技大学学报 (医学版), 2015, 44(5): 545-548.
11. 董然, 陈宝田, 刘韬帅, 等. 12 岁以下儿童心脏瓣膜置换术的临床特点及中远期随访. 实用儿科临床杂志, 2010, 25(13): 1024-1026.
12. Eble BK, Fiser WP, Simpson P, et al. Mitral valve replacement in children: predictors of long-term outcome. Ann Thorac Surg, 2003, 76(3): 853-859.
13. Williams DB, Danielson GK, McGoon DC, et al. Porcine heterograft valve replacement in children. J Thorac Cardiovasc Surg, 1982, 84(3): 446-450.
14. Guerra F, Bortolotti U, Thiene G, et al. Long-term performance of the Hancock porcine bioprosthesis in the tricuspid position. A review of forty-five patients with fourteen-year follow-up. J Thorac Cardiovasc Surg, 1990, 99(5): 838-845.
15. Brown ML, Dearani JA, Danielson GK, et al. Comparison of the outcome of porcine bioprosthetic versus mechanical prosthetic replacement of the tricuspid valve in the Ebstein anomaly. Am J Cardiol, 2009, 103(4): 555-561.
16. Said SM, Burkhart HM, Schaff HV, et al. When should a mechanical tricuspid valve replacement be considered? J Thorac Cardiovasc Surg, 2014, 148(2): 603-608.
17. Mohamed KS. Tricuspid valve replacement in infants and children with exclusively autologous tissue. World J Pediatr Congenit Heart Surg, 2017, 8(1): 88-91.
18. Hermsen JL, Permut LC, McQuinn TC, et al. Tricuspid valve replacement with a melody stented bovine jugular vein conduit. Ann Thorac Surg, 2014, 98(5): 1826-1827.
19. Fernandez-Doblas J, Perez-Andreu J, Betrian P, et al. Pediatric tricuspid valve replacement with transcatheter bioprosthetic valve: an alternative option in high-risk patients. Semin Thorac Cardiovasc Surg, 2019. [Epub ahead of print].
20. Topilsky Y, Khanna AD, Oh JK, et al. Preoperative factors associated with adverse outcome after tricuspid valve replacement. Circulation, 2011, 123(18): 1929-1939.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical outcome of tricuspid valve replacement in children aged no more than 14 years

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