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

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.