Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings
Objectives Surgical management of tricuspid valve regurgitation mainly consists of tricuspid valve annuloplasty, usually performed with implantation of a rigid ring or a flexible band. Methods We performed a retrospective analysis on 820 patients who underwent tricuspid valve repair between March 20...
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| creator | Pfannmüller, Bettina, MD Doenst, Torsten, MD, PHD Eberhardt, Katja, BS Seeburger, Jörg, MD Borger, Michael A., MD, PhD Mohr, Friedrich W., MD, PhD |
| description | Objectives Surgical management of tricuspid valve regurgitation mainly consists of tricuspid valve annuloplasty, usually performed with implantation of a rigid ring or a flexible band. Methods We performed a retrospective analysis on 820 patients who underwent tricuspid valve repair between March 2002 and July 2009 with either a flexible Cosgrove-Edwards band (n = 415; Edwards Lifesciences LLC, Irvine, Calif) or a rigid Carpentier-Edwards Classic annuloplasty ring (n = 405; Edwards Lifesciences). Mean patient age was 69.2 ± 9.5 years, 54.1% were female, and average logistic EuroSCORE was 13.3% ± 12.5%. Concomitant procedures were performed in 94.6% of patients (mitral valve surgery, 80.6%; aortic valve surgery, 28.2%; coronary artery bypass grafting, 24.5%; atrial fibrillation ablation, 44.5%). One fifth of the operations were reoperative procedures. Follow-up was 94% complete, with mean duration of 21.0 ± 19.0 months. Results Thirty-day mortality was 10.1% (Cosgrove-Edwards, 11.9%; Carpentier-Edwards, 8.4%), and 5-year survival was 62.4% (Carpentier-Edwards, 64.7%; Cosgrove-Edwards, 60.3%). Postoperative echocardiography showed significant improvement in tricuspid valve function, with reduction in tricuspid regurgitation grade from 2.3 ± 0.7 to 0.7 ± 0.7, and no differences between groups. Use of a Carpentier-Edwards ring, however, was associated with significantly higher risk of dehiscence (Carpentier-Edwards, 8.7%; Cosgrove-Edwards, 0.9%; P |
| doi_str_mv | 10.1016/j.jtcvs.2011.06.019 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1001958653</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0022522311006829</els_id><sourcerecordid>1001958653</sourcerecordid><originalsourceid>FETCH-LOGICAL-c489t-8b0ffe6505ce4b5d1e67e1f1b939bf958a0422e0483616f250f57a0f566c42de3</originalsourceid><addsrcrecordid>eNqFkUGL1TAQx4Mo7tvVTyBIL4KX1knapOlBQRZXFxY8qOgtpOlkN92-9plpn7xvb-p7KnjxksDw-2cmv2HsGYeCA1ev-qKf3Z4KAZwXoArgzQO24dDUudLy20O2ARAil0KUZ-ycqAeAOkGP2ZngdaOlKjfs6_XoIlrCLouB7rPJZx3eBXI4OsysnzFmcwxuoV3osr0d9phF3NkQsx9hvkuh21S347gM026wNB9SabylJ-yRtwPh09N9wb5cvft8-SG_-fj--vLtTe4q3cy5bsF7VBKkw6qVHUdVI_e8bcqm9Y3UFiohECpdKq68kOBlbdOhlKtEh-UFe3l8dxen7wvSbLbr8MNgR5wWMhzSj6VWskxoeURdnIgierOLYWvjIUFmNWp688uoWY0aUCZFU-r5qcHSbrH7k_mtMAEvToAlZwcf7egC_eWkrjVokbjXRw6Tjn3AaMiF1XIXIrrZdFP4zyBv_sm7IYwhtbzHA1I_LXFMpg03JAyYT-vy193zpEBp0ZQ_ASNLqsg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1001958653</pqid></control><display><type>article</type><title>Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>EZB Electronic Journals Library</source><creator>Pfannmüller, Bettina, MD ; Doenst, Torsten, MD, PHD ; Eberhardt, Katja, BS ; Seeburger, Jörg, MD ; Borger, Michael A., MD, PhD ; Mohr, Friedrich W., MD, PhD</creator><creatorcontrib>Pfannmüller, Bettina, MD ; Doenst, Torsten, MD, PHD ; Eberhardt, Katja, BS ; Seeburger, Jörg, MD ; Borger, Michael A., MD, PhD ; Mohr, Friedrich W., MD, PhD</creatorcontrib><description>Objectives Surgical management of tricuspid valve regurgitation mainly consists of tricuspid valve annuloplasty, usually performed with implantation of a rigid ring or a flexible band. Methods We performed a retrospective analysis on 820 patients who underwent tricuspid valve repair between March 2002 and July 2009 with either a flexible Cosgrove-Edwards band (n = 415; Edwards Lifesciences LLC, Irvine, Calif) or a rigid Carpentier-Edwards Classic annuloplasty ring (n = 405; Edwards Lifesciences). Mean patient age was 69.2 ± 9.5 years, 54.1% were female, and average logistic EuroSCORE was 13.3% ± 12.5%. Concomitant procedures were performed in 94.6% of patients (mitral valve surgery, 80.6%; aortic valve surgery, 28.2%; coronary artery bypass grafting, 24.5%; atrial fibrillation ablation, 44.5%). One fifth of the operations were reoperative procedures. Follow-up was 94% complete, with mean duration of 21.0 ± 19.0 months. Results Thirty-day mortality was 10.1% (Cosgrove-Edwards, 11.9%; Carpentier-Edwards, 8.4%), and 5-year survival was 62.4% (Carpentier-Edwards, 64.7%; Cosgrove-Edwards, 60.3%). Postoperative echocardiography showed significant improvement in tricuspid valve function, with reduction in tricuspid regurgitation grade from 2.3 ± 0.7 to 0.7 ± 0.7, and no differences between groups. Use of a Carpentier-Edwards ring, however, was associated with significantly higher risk of dehiscence (Carpentier-Edwards, 8.7%; Cosgrove-Edwards, 0.9%; P < .001), almost exclusively at the septal leaflet portion of the annulus. Multivariate analysis identified annuloplasty type as independently predicting ring dehiscence (odds ratio, 10.7; 95% confidence interval, 3.2–36.5; P < .001). Patients with annuloplasty dehiscence had more residual tricuspid regurgitation on predischarge echocardiography than did patients without dehiscence (1.4 ± 0.63 vs 0.7 ± 0.6; P < .001). Ten patients underwent reoperation for recurrent tricuspid regurgitation, 4 with ring dehiscence. Five-year freedom from reoperation was 95.3% (Cosgrove-Edwards, 97.7%; Carpentier-Edwards, 92.3%). Conclusions Although both rigid and flexible systems provide acceptable early tricuspid valve repair results, use of a rigid ring increases risk of subsequent ring dehiscence.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2011.06.019</identifier><identifier>PMID: 21798563</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiac Valve Annuloplasty - adverse effects ; Cardiac Valve Annuloplasty - instrumentation ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Female ; Germany ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation - adverse effects ; Heart Valve Prosthesis Implantation - instrumentation ; Humans ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Middle Aged ; Odds Ratio ; Pneumology ; Prosthesis Design ; Reoperation ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Surgical Wound Dehiscence - diagnostic imaging ; Surgical Wound Dehiscence - etiology ; Surgical Wound Dehiscence - mortality ; Surgical Wound Dehiscence - surgery ; Time Factors ; Treatment Outcome ; Tricuspid Valve - diagnostic imaging ; Tricuspid Valve - surgery ; Tricuspid Valve Insufficiency - diagnostic imaging ; Tricuspid Valve Insufficiency - mortality ; Tricuspid Valve Insufficiency - surgery ; Ultrasonography</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2012-05, Vol.143 (5), p.1050-1055</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2012 The American Association for Thoracic Surgery</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-8b0ffe6505ce4b5d1e67e1f1b939bf958a0422e0483616f250f57a0f566c42de3</citedby><cites>FETCH-LOGICAL-c489t-8b0ffe6505ce4b5d1e67e1f1b939bf958a0422e0483616f250f57a0f566c42de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jtcvs.2011.06.019$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25878082$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21798563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pfannmüller, Bettina, MD</creatorcontrib><creatorcontrib>Doenst, Torsten, MD, PHD</creatorcontrib><creatorcontrib>Eberhardt, Katja, BS</creatorcontrib><creatorcontrib>Seeburger, Jörg, MD</creatorcontrib><creatorcontrib>Borger, Michael A., MD, PhD</creatorcontrib><creatorcontrib>Mohr, Friedrich W., MD, PhD</creatorcontrib><title>Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objectives Surgical management of tricuspid valve regurgitation mainly consists of tricuspid valve annuloplasty, usually performed with implantation of a rigid ring or a flexible band. Methods We performed a retrospective analysis on 820 patients who underwent tricuspid valve repair between March 2002 and July 2009 with either a flexible Cosgrove-Edwards band (n = 415; Edwards Lifesciences LLC, Irvine, Calif) or a rigid Carpentier-Edwards Classic annuloplasty ring (n = 405; Edwards Lifesciences). Mean patient age was 69.2 ± 9.5 years, 54.1% were female, and average logistic EuroSCORE was 13.3% ± 12.5%. Concomitant procedures were performed in 94.6% of patients (mitral valve surgery, 80.6%; aortic valve surgery, 28.2%; coronary artery bypass grafting, 24.5%; atrial fibrillation ablation, 44.5%). One fifth of the operations were reoperative procedures. Follow-up was 94% complete, with mean duration of 21.0 ± 19.0 months. Results Thirty-day mortality was 10.1% (Cosgrove-Edwards, 11.9%; Carpentier-Edwards, 8.4%), and 5-year survival was 62.4% (Carpentier-Edwards, 64.7%; Cosgrove-Edwards, 60.3%). Postoperative echocardiography showed significant improvement in tricuspid valve function, with reduction in tricuspid regurgitation grade from 2.3 ± 0.7 to 0.7 ± 0.7, and no differences between groups. Use of a Carpentier-Edwards ring, however, was associated with significantly higher risk of dehiscence (Carpentier-Edwards, 8.7%; Cosgrove-Edwards, 0.9%; P < .001), almost exclusively at the septal leaflet portion of the annulus. Multivariate analysis identified annuloplasty type as independently predicting ring dehiscence (odds ratio, 10.7; 95% confidence interval, 3.2–36.5; P < .001). Patients with annuloplasty dehiscence had more residual tricuspid regurgitation on predischarge echocardiography than did patients without dehiscence (1.4 ± 0.63 vs 0.7 ± 0.6; P < .001). Ten patients underwent reoperation for recurrent tricuspid regurgitation, 4 with ring dehiscence. Five-year freedom from reoperation was 95.3% (Cosgrove-Edwards, 97.7%; Carpentier-Edwards, 92.3%). Conclusions Although both rigid and flexible systems provide acceptable early tricuspid valve repair results, use of a rigid ring increases risk of subsequent ring dehiscence.</description><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiac Valve Annuloplasty - adverse effects</subject><subject>Cardiac Valve Annuloplasty - instrumentation</subject><subject>Cardiology. Vascular system</subject><subject>Cardiothoracic Surgery</subject><subject>Female</subject><subject>Germany</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation - adverse effects</subject><subject>Heart Valve Prosthesis Implantation - instrumentation</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Pneumology</subject><subject>Prosthesis Design</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Surgical Wound Dehiscence - diagnostic imaging</subject><subject>Surgical Wound Dehiscence - etiology</subject><subject>Surgical Wound Dehiscence - mortality</subject><subject>Surgical Wound Dehiscence - surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Tricuspid Valve - diagnostic imaging</subject><subject>Tricuspid Valve - surgery</subject><subject>Tricuspid Valve Insufficiency - diagnostic imaging</subject><subject>Tricuspid Valve Insufficiency - mortality</subject><subject>Tricuspid Valve Insufficiency - surgery</subject><subject>Ultrasonography</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUGL1TAQx4Mo7tvVTyBIL4KX1knapOlBQRZXFxY8qOgtpOlkN92-9plpn7xvb-p7KnjxksDw-2cmv2HsGYeCA1ev-qKf3Z4KAZwXoArgzQO24dDUudLy20O2ARAil0KUZ-ycqAeAOkGP2ZngdaOlKjfs6_XoIlrCLouB7rPJZx3eBXI4OsysnzFmcwxuoV3osr0d9phF3NkQsx9hvkuh21S347gM026wNB9SabylJ-yRtwPh09N9wb5cvft8-SG_-fj--vLtTe4q3cy5bsF7VBKkw6qVHUdVI_e8bcqm9Y3UFiohECpdKq68kOBlbdOhlKtEh-UFe3l8dxen7wvSbLbr8MNgR5wWMhzSj6VWskxoeURdnIgierOLYWvjIUFmNWp688uoWY0aUCZFU-r5qcHSbrH7k_mtMAEvToAlZwcf7egC_eWkrjVokbjXRw6Tjn3AaMiF1XIXIrrZdFP4zyBv_sm7IYwhtbzHA1I_LXFMpg03JAyYT-vy193zpEBp0ZQ_ASNLqsg</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Pfannmüller, Bettina, MD</creator><creator>Doenst, Torsten, MD, PHD</creator><creator>Eberhardt, Katja, BS</creator><creator>Seeburger, Jörg, MD</creator><creator>Borger, Michael A., MD, PhD</creator><creator>Mohr, Friedrich W., MD, PhD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings</title><author>Pfannmüller, Bettina, MD ; Doenst, Torsten, MD, PHD ; Eberhardt, Katja, BS ; Seeburger, Jörg, MD ; Borger, Michael A., MD, PhD ; Mohr, Friedrich W., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-8b0ffe6505ce4b5d1e67e1f1b939bf958a0422e0483616f250f57a0f566c42de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiac Valve Annuloplasty - adverse effects</topic><topic>Cardiac Valve Annuloplasty - instrumentation</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Female</topic><topic>Germany</topic><topic>Heart Valve Prosthesis</topic><topic>Heart Valve Prosthesis Implantation - adverse effects</topic><topic>Heart Valve Prosthesis Implantation - instrumentation</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Pneumology</topic><topic>Prosthesis Design</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Surgical Wound Dehiscence - diagnostic imaging</topic><topic>Surgical Wound Dehiscence - etiology</topic><topic>Surgical Wound Dehiscence - mortality</topic><topic>Surgical Wound Dehiscence - surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Tricuspid Valve - diagnostic imaging</topic><topic>Tricuspid Valve - surgery</topic><topic>Tricuspid Valve Insufficiency - diagnostic imaging</topic><topic>Tricuspid Valve Insufficiency - mortality</topic><topic>Tricuspid Valve Insufficiency - surgery</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pfannmüller, Bettina, MD</creatorcontrib><creatorcontrib>Doenst, Torsten, MD, PHD</creatorcontrib><creatorcontrib>Eberhardt, Katja, BS</creatorcontrib><creatorcontrib>Seeburger, Jörg, MD</creatorcontrib><creatorcontrib>Borger, Michael A., MD, PhD</creatorcontrib><creatorcontrib>Mohr, Friedrich W., MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pfannmüller, Bettina, MD</au><au>Doenst, Torsten, MD, PHD</au><au>Eberhardt, Katja, BS</au><au>Seeburger, Jörg, MD</au><au>Borger, Michael A., MD, PhD</au><au>Mohr, Friedrich W., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>143</volume><issue>5</issue><spage>1050</spage><epage>1055</epage><pages>1050-1055</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Objectives Surgical management of tricuspid valve regurgitation mainly consists of tricuspid valve annuloplasty, usually performed with implantation of a rigid ring or a flexible band. Methods We performed a retrospective analysis on 820 patients who underwent tricuspid valve repair between March 2002 and July 2009 with either a flexible Cosgrove-Edwards band (n = 415; Edwards Lifesciences LLC, Irvine, Calif) or a rigid Carpentier-Edwards Classic annuloplasty ring (n = 405; Edwards Lifesciences). Mean patient age was 69.2 ± 9.5 years, 54.1% were female, and average logistic EuroSCORE was 13.3% ± 12.5%. Concomitant procedures were performed in 94.6% of patients (mitral valve surgery, 80.6%; aortic valve surgery, 28.2%; coronary artery bypass grafting, 24.5%; atrial fibrillation ablation, 44.5%). One fifth of the operations were reoperative procedures. Follow-up was 94% complete, with mean duration of 21.0 ± 19.0 months. Results Thirty-day mortality was 10.1% (Cosgrove-Edwards, 11.9%; Carpentier-Edwards, 8.4%), and 5-year survival was 62.4% (Carpentier-Edwards, 64.7%; Cosgrove-Edwards, 60.3%). Postoperative echocardiography showed significant improvement in tricuspid valve function, with reduction in tricuspid regurgitation grade from 2.3 ± 0.7 to 0.7 ± 0.7, and no differences between groups. Use of a Carpentier-Edwards ring, however, was associated with significantly higher risk of dehiscence (Carpentier-Edwards, 8.7%; Cosgrove-Edwards, 0.9%; P < .001), almost exclusively at the septal leaflet portion of the annulus. Multivariate analysis identified annuloplasty type as independently predicting ring dehiscence (odds ratio, 10.7; 95% confidence interval, 3.2–36.5; P < .001). Patients with annuloplasty dehiscence had more residual tricuspid regurgitation on predischarge echocardiography than did patients without dehiscence (1.4 ± 0.63 vs 0.7 ± 0.6; P < .001). Ten patients underwent reoperation for recurrent tricuspid regurgitation, 4 with ring dehiscence. Five-year freedom from reoperation was 95.3% (Cosgrove-Edwards, 97.7%; Carpentier-Edwards, 92.3%). Conclusions Although both rigid and flexible systems provide acceptable early tricuspid valve repair results, use of a rigid ring increases risk of subsequent ring dehiscence.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>21798563</pmid><doi>10.1016/j.jtcvs.2011.06.019</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The Journal of thoracic and cardiovascular surgery, 2012-05, Vol.143 (5), p.1050-1055 |
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| subjects | Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiac Valve Annuloplasty - adverse effects Cardiac Valve Annuloplasty - instrumentation Cardiology. Vascular system Cardiothoracic Surgery Female Germany Heart Valve Prosthesis Heart Valve Prosthesis Implantation - adverse effects Heart Valve Prosthesis Implantation - instrumentation Humans Kaplan-Meier Estimate Male Medical sciences Middle Aged Odds Ratio Pneumology Prosthesis Design Reoperation Retrospective Studies Risk Assessment Risk Factors Surgical Wound Dehiscence - diagnostic imaging Surgical Wound Dehiscence - etiology Surgical Wound Dehiscence - mortality Surgical Wound Dehiscence - surgery Time Factors Treatment Outcome Tricuspid Valve - diagnostic imaging Tricuspid Valve - surgery Tricuspid Valve Insufficiency - diagnostic imaging Tricuspid Valve Insufficiency - mortality Tricuspid Valve Insufficiency - surgery Ultrasonography |
| title | Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings |
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