Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2022; 10(15): 4810-4817
Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.4810
Application effect of thoracoscopic tricuspid valvuloplasty in geriatric patients with tricuspid valve disease
Wei Jiang, Xiao-Mao Long, Ke-Quan Wei, Si-Cong Li, Ze Zhang, Bang-Fu He, Hui Li
Wei Jiang, Xiao-Mao Long, Ke-Quan Wei, Si-Cong Li, Ze Zhang, Bang-Fu He, Hui Li, Department of Cardiothoracic and Vascular Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Jiang W and Long XM designed this retrospective study; Jiang W wrote this manuscript; Jiang W, Long XM, Wei KQ, Li SC, Zhang Z, He BF and Lin H were responsible for sorting the data; and all authors have read and approve the final manuscript.
Supported by Natural Science Foundation of Guangxi Zhuang Autonomous Region of China, No. 2016GXNSFAA380079.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the People’s Hospital of Guangxi Zhuang Autonomous Region. Institutional Review Board (Approval No. KY-LW-201802).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Mao Long, MD, Chief Physician, Department of Cardiothoracic and Vascular Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, No. 6 Taoyuan Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China. longluke369@163.com
Received: January 10, 2022
Peer-review started: January 10, 2022
First decision: February 14, 2022
Revised: February 28, 2022
Accepted: March 26, 2022
Article in press: March 26, 2022
Published online: May 26, 2022
Processing time: 134 Days and 6.5 Hours
Abstract
BACKGROUND

Thoracoscopic-assisted technology can ensure that doctors can implement minimally invasive treatment through the right intercostal incision or small incision of the lower sternum. This approach not only can achieve a cardiac correction effect equivalent to that of a thoracotomy but also has the benefit of a clear surgical field ensuring the safety of surgical treatment.

AIM

To investigate the effect of thoracoscopic tricuspid valvuloplasty in patients with tricuspid valve disease.

METHODS

A total of 41 patients with tricuspid valve disease underwent traditional thoracotomy treatment between January 2018 and June 2020. Forty-one patients with tricuspid valve disease who underwent thoracoscopic tricuspid valvuloplasty treatment between July 2020 and June 2021 in our hospital were selected as controls for our retrospective analysis. The study group underwent thoracoscopic tricuspid valvuloplasty, while traditional thoracotomy was performed in the control group. The operation conditions (the duration of extracorporeal circulation, aorta blocking, endotracheal intubation, and surgery), inflammatory response-related indices (C-reactive protein and white blood cell count) before and after surgery, parameters related to myocardial injury (myocardial troponin T, creatine kinase isoenzyme, creatine kinase, and lactate dehydrogenase), and the incidence of adverse events in the two groups was counted.

RESULTS

The duration of extracorporeal circulation (109.35 ± 50.31 min), aortic occlusion (94.26 ± 59.61 min), endotracheal intubation (12.59 ± 3.54 h), and hospital stay (5.29 ± 2.34 d) in the study group were shorter than those in the control group (114.91 ± 46.98 min, 101.37 ± 61.44 min, 13.11 ± 4.01 h, 7.09 ± 3.11 d, respectively). The difference in hospital stay between the two groups was statistically significant (P < 0.05). Serum C-reactive protein level (4.69 ± 1.35 mg/L) and white blood cell count (6.21 ± 1.97 × 109/L) in the study group were found to be not significantly different than those in the control group (5.01 ± 1.18 mg/L, 5.98 ± 2.01 × 109/L, respectively; P > 0.05). Myocardial troponin T (0.04 ± 0.02 ng/mL), creatine kinase isoenzyme (4.02 ± 1.11 mg/mL), creatine kinase (91.35 ± 10.44 U/L), and lactate dehydrogenase (179.81 ± 60.04 U/L) in the study group were also not statistically significant different than those in the control group (0.05 ± 0.03 ng/mL, 3.97 ± 1.05 mg/mL, 89.69 ± 13.05 U/L, 186.35 ± 56.96 U/L; P > 0.05). After the operation, serum C-reactive protein level (7.89 ± 1.73 mg/L) and white blood cell count (10.76 ± 2.35 × 109/L) in the study group were significantly lower than those in the control group (9.96 ± 2.04 mg/L, 14.84 ± 3.07 × 109/L, respectively) (P < 0.05). In addition, myocardial troponin T (0.89 ± 0.32 ng/mL), creatine kinase isoenzyme (26.96 ± 4.95 mg/mL), creatine kinase (608.32 ± 202.33 U/L), and lactate dehydrogenase (282.56 ± 101.34 U/L) in the study group were lower than those in the control group (2.61 ± 0.69 ng/mL, 34.37 ± 6.87 mg/mL, 689.94 ± 214.64 U/L, 369.15 ± 114.46 U/L) (P < 0.05). The incidence of adverse events in the study group (4.88%) was lower than that in the control group (19.51%) (P < 0.05).

CONCLUSION

Thoracoscopic tricuspid valvuloplasty can achieve good results in treating patients with tricuspid valve disease, reduce the risk of adverse events, and promote the rapid recovery of patients.

Keywords: Senile tricuspid valve disease; Thoracoscopic tricuspid valvuloplasty; Inflammatory reaction; Myocardial injury

Core Tip: Thoracoscopic tricuspid valvuloplasty can achieve good results in treating geriatric patients with tricuspid valve disease, which can cause a slight inflammatory reaction and myocardial injury, reduce the risk of adverse events, and promote the recovery of patients in the hospital. However, this study is a retrospective study, so the clinical value of the results still needs to be further confirmed by prospective studies.