Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation.

Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation. Abstract Text:

Daniel Marelli,Scott C Silvestry,Donna Zwas,Paul Mather,Sharon Rubin,Anthony F Dempsey,Louis Stein,Evelio Rodriguez,James T Diehl,Arthur M Feldman,

Postoperative tricuspid valve regurgitation is moderate to severe in 15% to 20% of heart transplant recipients despite use of the bicaval surgical technique. We hypothesized that the regurgitation might be partly due to increased tension on the donor right atrium.To study the right atrial distortion, we modified the standard bicaval anastomosis. Our technique involves augmenting the donor right atrial anterior wall with a flap of the recipient's right atrium, which is left attached in continuity with the anterior aspect of the inferior vena cava along 65% of its circumference.We measured tricuspid regurgitation, right atrial area, and right atrioventricular diameter in 7 consecutive patients who underwent orthotopic heart transplantation with the modified anastomosis. Tricuspid regurgitation was graded as follows: 1 = trace, <10%; 2 = mild, 10%-24%; 3 = moderate, 25%-50%; and 4 = severe, >50%.All patients were weaned from inotropic support within 1 week after transplantation with excellent ventricular function, no heart block, and 100% survival at 30 days. The median follow-up time was 173 days (44-358 days). Other median measurements included tricuspid valve regurgitation jet area, 0.30 cm(2) (0-1.90 cm(2)); right atrial area, 15.90 cm(2) (14.47-18.00 cm(2)); atrioventricular diameter, 2.70 cm (2.63-3.09 cm); and tricuspid regurgitation, 1.67% (0-12.42%). Mild regurgitation occurred in 1 recipient; in all others, it was trace.The modified inferior vena caval anastomosis is simple and safe. It eliminates moderate and severe tricuspid valve regurgitation without routine annuloplasty after orthotopic heart transplantation via the bicaval technique.

Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation. Publishing Authors By Initials

D Marelli,SC Silvestry,D Zwas,P Mather,S Rubin,AF Dempsey,L Stein,E Rodriguez,JT Diehl,AM Feldman,

For similar circulatory and respiratory physiology: cardiovascular physiology: cardiovascular physiologic processes: ventricular function research abstracts see: circulatory and respiratory physiology: cardiovascular physiology: cardiovascular physiologic processes: ventricular function research

PUBMED ID PMID:

MEDLINE DATE:

Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Texas Heart Institute journal / from the Texas Hea

VOLUME: 34

Page Numbers: 30-5

Journal Abbreviation:

ISSN: 0730-2347

DAY: 3

MONTH: 12

YEAR: 2007

Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 8214622

Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation. Keywords Mesh Terms:

KEYWORDS: Ventricular Function

MESH TERMS: ultrasonography

Chemical & Substance for Abstract: Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation.

AFFILIATION: Division of Cardiothoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.

Country: United States

AGENCY: United States NHLBI

GRANT: T35-HL07845-06A1

ACRONYM: HL

MEDLINETA: Tex Heart Inst J

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation Related Publications

• A stretch reflex in extraocular muscles of species purportedly lacking muscle spindles.
• A unique insertion/duplication in the VDR gene that truncates the VDR causing hereditary 1,25-dihydroxyvitamin D-resistant rickets without alopecia.
• Appropriate management of lower respiratory tract infections in primary care.
• Are CD4 and Fas peptide identities of gp120 relevant to the molecular basis of AIDS pathogenesis?
• Assessment of differences in HLA-A, -B, and -DRB1 allele mismatches among African-American and non-African-American recipients of deceased kidney transplants.
• Barriers to psychotherapy among depressed and nondepressed primary care patients.
• Calcitriol and genistein actions to inhibit the prostaglandin pathway: potential combination therapy to treat prostate cancer.
• Congenital and acquired toxoplasmosis.
• Cultural niche construction in a metapopulation.
• Detection of vulnerable plaque in a murine model of atherosclerosis with optical coherence tomography.
• Determination of visual figure and ground in dynamically deforming shapes.
• Diabetic neuropathies.
• Difference between evolutionarily effective and germ line mutation rate due to stochastically varying haplogroup size.
• Efficient measurement of endogenous neurotransmitters in small localized regions of central nervous systems in vitro with HPLC.
• Evolutionary theory for modifiers of epistasis using a general symmetric model.
• Micro-agar salt bridge in patch-clamp electrode holder stabilizes electrode potentials.
• Modified inferior vena caval anastomosis to reduce tricuspid valve regurgitation after heart transplantation.
• New lower nicotine cigarettes can produce compensatory smoking and increased carbon monoxide exposure.
• New tools, old challenges: the emerging role of angiotensin receptor blockers in the treatment of the systolic hypertension epidemic.
• Novel pathways that contribute to the anti-proliferative and chemopreventive activities of calcitriol in prostate cancer.
• On the evolution of epistasis II: a generalized Wright-Kimura framework.
• Phylogenetics of the woodrat genus Neotoma (Rodentia: Muridae): implications for the evolution of phenotypic variation in male external genitalia.
• Postnatal development of cannabinoid receptor type 1 expression in rodent somatosensory cortex.
• Receptor for advanced glycation end products activation injures primary sensory neurons via oxidative stress.
• Regions of low endothelial shear stress are the sites where coronary plaque progresses and vascular remodelling occurs in humans: an in vivo serial study.
• Regulated overexpression of the A1-adenosine receptor in mice results in adverse but reversible changes in cardiac morphology and function.
• Retrospective evaluation of three treatment methods for primary hyperparathyroidism in dogs.
• Serum glucose levels and alcohol-consumption habits in a large population.
• The Cancer Biomedical Informatics Grid (caBIG^TM).
• What is altruism?