Tricuspid Valve Functionality And Heart Transplantation. Impact Of Surgical Technique

Introduction. We herein describe the impact of functional tricuspid regurgitation (RT) after orthotopic heart transplantation (TxC) and analyze our own series of uninterrupted TxC during the period 1998-2011.Methods. A total of 778 consecutive procedures of TxC were carried out at Clinica Puerta de Hierro since 1984, of which a series of 355 were studied in terms of a surgical-preservation technique of sinus node function, namely, the standard (bi-atrial; n = 278) or the more recent cavo-atrial (n = 77) anastomosis of the right atria.Results. An attempt was made to find discriminative parameters between both approaches regarding postoperative complications and long-term survival. A significant (p = 0.03) difference was found in body mass index favoring the bi-atrial technique, but no deleterious effects in case of sex discrepancy of donor/recipient could be found. A longer (p = 0.02) graft ischemic time and pump run (p < 0.001) were associated with the cavo-atrial technique, but also a reduced early dependency of pacemaker (p = 0.03) triggering.Functional RT is frequently ascertained following TxC, with potentially significant severity. Technical modifications, such as cavo-atrial anastomosis and prophylactic tricuspid annuloplasty, convey a degree of clinical protection in terms of preserved sinus node function and tricuspid valve coaptation. No effects on long-term survival could be found in this study.