OBJECTIVES: To determine the long-term and transplantation-free survival of all patients after atrial correction of transposition of the great arteries (TGA) in the Czech and Slovak republics, including its preoperative and perioperative determinants. METHODS: Retrospective analysis of all 454 consecutive patients after atrial correction of TGA was performed. Of these, 126 (27.8%) were female, median age at operation was 7.4 months (Q1 5.3; Q3 13.3) and 164 (36.1%) underwent the Mustard procedure. The relationships between age, weight, the complexity of TGA, operative technique, additional surgical procedures, immediate postoperative presence of tricuspid regurgitation and revision procedures during follow-up to major composite outcome, as such defined as long-term and transplantation-free survival, were tested. RESULTS: Early 30-day mortality did not differ between the Mustard (9.76%) and Senning (8.97%) cohorts (p=0.866). The long-term and transplantation-free survival, which differed between the Mustard and Senning cohorts in favour of the Senning procedure (HR 0.43; 95% CI 0.21 to 0.87), was shorter in complex TGA (HR 2.4; 95% CI 1.59 to 3.78) and in complex surgical interventions (HR 3.51; 95% CI 2.31 to 5.56). The immediate presence of at least moderate tricuspid regurgitation after correction was associated with a shorter long-term and transplantation-free survival in the univariate but not in the multivariable model. CONCLUSIONS: The lower long-term survival of patients after an atrial switch operation of TGA in the Czech and Slovak republics is associated with greater complexity of TGA, complex surgical interventions and application of the the Mustard operative procedure.

• Klíčová slova
• heart defects, congenital, transposition of great vessels, tricuspid valve insufficiency,
• MeSH
• arterie MeSH
• kojenec MeSH
• korekce transpozice velkých arterií * škodlivé účinky   MeSH
• lidé MeSH
• následné studie MeSH
• retrospektivní studie MeSH
• transpozice velkých cév * MeSH
• trikuspidální insuficience * chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Data on the impact and course of uncorrected tricuspid regurgitation (TR) during left ventricular assist device (LVAD) implantation are scarce and inconsistent. This study explores the clinical impact and natural course of uncorrected TR in patients after LVAD implantation. METHODS: The European Registry for Patients with Mechanical Circulatory Support was used to identify adult patients with LVAD implants without concomitant tricuspid valve surgery. A mediation model was developed to assess the association of TR with 30-day mortality via other risk factors. Generalized mixed models were used to model the course of post-LVAD TR. Joint models were used to perform sensitivity analyses. RESULTS: A total of 2496 procedures were included (median age: 56 years; men: 83%). TR was not directly associated with higher 30-day mortality, but mediation analyses suggested an indirect association via preoperative elevated right atrial pressure and creatinine (P = 0.035) and bilirubin (P = 0.027) levels. Post-LVAD TR was also associated with increased late mortality [hazard ratio 1.16 (1.06-1.3); P = 0.001]. On average, uncorrected TR diminished after LVAD implantation. The probability of having moderate-to-severe TR immediately after an implant in patients with none-to-mild TR pre-LVAD was 10%; in patients with moderate-to-severe TR pre-LVAD, it was 35% and continued to decrease in patients with moderate-to-severe TR pre-LVAD, regardless of pre-LVAD right ventricular failure or pulmonary hypertension. CONCLUSIONS: Uncorrected TR pre-LVAD and post-LVAD is associated with increased early and late mortality. Nevertheless, on average, TR diminishes progressively without intervention after an LVAD implant. Therefore, these data suggest that patient selection for concomitant tricuspid valve surgery should not be based solely on TR grade.

• Klíčová slova
• Left ventricular assist device, Mortality, Natural course, Tricuspid regurgitation,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• podpůrné srdeční systémy * škodlivé účinky   MeSH
• registrace MeSH
• retrospektivní studie MeSH
• srdeční selhání * chirurgie   MeSH
• trikuspidální insuficience * epidemiologie   chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Tricuspid regurgitation (TR) is common in patients receiving a left ventricular assist device (LVAD). Controversy exists as to whether concomitant tricuspid valve surgery (TVS) is beneficial in currently treated patients. Therefore, our goal was to investigate the effect of TVS concomitant with a LVAD implant. METHODS: The European Registry for Patients with Mechanical Circulatory Support was used to identify adult patients. Matched patients with and without concomitant TVS were compared using a propensity score matching strategy. RESULTS: In total, 3323 patients underwent LVAD implantation of which 299 (9%) had TVS. After matching, 258 patients without TVS were matched to 258 patients with TVS. In the matched population, hospital deaths, days on inotropic support, temporary right ventricular assist device implants and hospital stay were comparable, whereas stay in the intensive care unit was higher in the TVS cohort (11 vs 15 days; P = 0.026). Late deaths (P = 0.17), cumulative incidence of unexpected hospital readmission (P = 0.15) and right heart failure (P = 0.55) were comparable between patients with and without concomitant TVS. In the matched population, probability of moderate-to-severe TR immediately after surgery was lower in patients with concomitant TVS compared to patients without TVS (33% vs 70%; P = 0.001). Nevertheless, the probability of moderate-to-severe TR decreased more quickly in patients without TVS (P = 0.030), resulting in comparable probabilities of moderate-to-severe TR within 1.5 years of follow-up. CONCLUSIONS: In matched patients, TVS concomitant with LVAD implant does not seem to be associated with better clinical outcomes. Concomitant TVS reduced TR significantly early after LVAD implant; however, differences in probability of TR disappeared during the follow-up period.

• Klíčová slova
• Clinical outcomes, Left ventricular assist device, Tricuspid valve, Tricuspid valve surgery,
• MeSH
• chirurgická náhrada chlopně * škodlivé účinky   mortalita   statistika a číselné údaje   MeSH
• délka pobytu statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• podpůrné srdeční systémy * škodlivé účinky   statistika a číselné údaje   MeSH
• registrace MeSH
• retrospektivní studie MeSH
• srdeční selhání epidemiologie   chirurgie   MeSH
• tendenční skóre MeSH
• trikuspidální chlopeň chirurgie   MeSH
• trikuspidální insuficience * epidemiologie   chirurgie   MeSH
• výsledek terapie MeSH
• znovupřijetí pacienta statistika a číselné údaje   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• anuloplastika srdeční chlopně metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• trikuspidální chlopeň chirurgie   MeSH
• trikuspidální insuficience chirurgie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• audiovizuální média MeSH
• úvodníky MeSH

A 53-year-old female with idiopathic hypereosinophilic syndrome underwent recurrent tricuspid valve replacement for Löffler's endocarditis. We review the literature on tricuspid valve surgery in patients with this uncommon disorder.

• MeSH
• bioprotézy * MeSH
• chirurgická náhrada chlopně metody   MeSH
• eozinofilie prevence a kontrola   MeSH
• hypereozinofilní syndrom komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• perioperační péče MeSH
• pooperační komplikace prevence a kontrola   MeSH
• trikuspidální chlopeň chirurgie   MeSH
• trikuspidální insuficience etiologie   chirurgie   MeSH
• trombóza prevence a kontrola   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

The concept of vena contracta space reduction in tricuspid valve position was tested in an animal model. Feasibility of specific artificial obturator body (REMOT) fixed to the right ventricular apex and interacting with tricuspid valve leaflets was evaluated in three different animal studies. Catheter-based technique was used in three series of experiment in 7 sheep. First acute study was designed for evaluation if the screwing mode of guide wire anchoring to the right ventricular apex is feasible for the whole REMOT body fixing. Longer study was aimed to evaluate stability of the REMOT body in desired position when fixing the screwing wire on its both ends (to the right ventricular apex and to the skin in the neck area). X-ray methods and various morphological methods were used. The third acute study was intended to the REMOT body deployment without any fixing wire. In all of 7 sheep the REMOT was successfully inserted into the right heart cavities and then fixed to the right ventricular apex area. When the REMOT was left in situ more than 6 months it was stable, induced adhesion to the tricuspid valve leaflet and was associated with a specific cell invasion. Releasing of the REMOT from the guiding tools was also successfully verified. Deployment of the obturator body in the aim to reduce the tricuspid valve orifice is feasible and well tolerated in the short and longer term animal model. Specific cell colonization including neovascularization of the obturator body was observed.

• MeSH
• chirurgická náhrada chlopně metody   MeSH
• ovce MeSH
• pilotní projekty MeSH
• studie proveditelnosti MeSH
• trikuspidální chlopeň patologie   chirurgie   MeSH
• trikuspidální insuficience patologie   chirurgie   MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Cardiac sarcoidosis is a rare entity and may be difficult to diagnose prior to cardiac surgery. We review the imaging and diagnostic studies necessary to make the diagnosis and discuss therapeutic algorithms to manage this disease.

• MeSH
• anuloplastika srdeční chlopně MeSH
• diagnostické zobrazování MeSH
• dysfunkce levé srdeční komory diagnóza   etiologie   terapie   MeSH
• fatální výsledek MeSH
• fibrilace síní diagnóza   etiologie   terapie   MeSH
• kardiomyopatie komplikace   diagnóza   patologie   MeSH
• lidé MeSH
• mitrální insuficience etiologie   chirurgie   MeSH
• myokard patologie   MeSH
• sarkoidóza komplikace   diagnóza   patologie   MeSH
• senioři MeSH
• srdeční blokáda diagnóza   etiologie   terapie   MeSH
• trikuspidální insuficience etiologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

Traumatic tricuspid regurgitation is a rare disease owing to penetrating or nonpenetrating thoracic trauma. In the last 40 years, since motorism is increasing, this disease can be seen more frequently. In most cases, rupture of chordae tendinae on the tricuspid valve, damage of the front papillary muscle and rupture of the tricuspid valve leaflets. On an acute stage, the damage of the valve can remain undiagnosed. Later on, the patient might have no symptoms; however, symtoms of right heart failure indicating an operation appear. This case-study is concerned with a patient with traumatic tricuspid regurgitation.

• MeSH
• dopravní nehody MeSH
• dospělí MeSH
• lidé MeSH
• poranění hrudníku komplikace   MeSH
• poranění srdce etiologie   chirurgie   MeSH
• trikuspidální chlopeň zranění   chirurgie   MeSH
• trikuspidální insuficience etiologie   chirurgie   MeSH
• tupá poranění komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

The long-term results on 36 patients undergoing tricuspid annuloplasty according to DeVega over the years 1981-1990 were analyzed. All had mitral valve replacement or repair in addition to the above procedure. Moreover, three patients had aortic valve replacement while aortocoronary bypass and interatrial septal defect closure was performed in two cases each. Duration of follow-up ranged between 6 to 72 months (mean 36 months). All patients were examined by echocardiography. Significant tricuspid regurgitation was found in three of the patients operated on, manifest clinical signs of the condition were present in one female patient only. Functional evaluation reassigned 72% of the operated patients from Class III and IV to Class I and II, and apparent subjective improvement was reported by 81% of patients. The analysis showed that indication of patients for simultaneous management of tricuspid regurgitation associated with mitral valve disease is justified, and that the surgical technique employed is appropriate.

• MeSH
• aortální chlopeň chirurgie   MeSH
• lidé MeSH
• metody MeSH
• mitrální chlopeň chirurgie   MeSH
• následné studie MeSH
• srdeční chlopně umělé MeSH
• trikuspidální chlopeň chirurgie   MeSH
• trikuspidální insuficience chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• aortální insuficience chirurgie   MeSH
• aortální stenóza chirurgie   MeSH
• dítě MeSH
• dospělí MeSH
• hemodynamika MeSH
• lidé MeSH
• metody MeSH
• mitrální insuficience chirurgie   MeSH
• mitrální stenóza chirurgie   MeSH
• nemoci srdečních chlopní chirurgie   MeSH
• trikuspidální insuficience chirurgie   MeSH
• trikuspidální stenóza chirurgie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH