ArticleInternational journal of surgery case reports2026
Totally endoscopic beating-heart redo tricuspid valve replacement using a frame-preserving strategy: a case report.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Redo tricuspid valve surgery for structural bioprosthetic degeneration is technically challenging and carries substantial operative risk, particularly after previous sternotomy. Totally endoscopic approaches may reduce re-entry-related morbidity, but experience in redo tricuspid surgery remains limited. In selected cases, preserving a well-incorporated bioprosthetic frame may avoid extensive annular dissection. Case presentation: A 46-year-old man presented with progressive right-sided heart failure 11 years after tricuspid bioprosthetic valve replacement for infective endocarditis. Echocardiography showed severe intra-prosthetic regurgitation and stenosis with calcified, retracted leaflets. Transcatheter valve-in-valve therapy was considered but not selected because of the patient's young age, durability concerns, limited availability, and cost. Totally endoscopic beating-heart redo tricuspid valve replacement was performed through a right mini-thoracotomy under peripheral cardiopulmonary bypass. The degenerated leaflets were excised, the sewing ring was preserved, and a 29-mm mechanical prosthesis was implanted onto the retained frame. Recovery was uneventful, and valve function was normal at 6 months. Conclusion: This frame-preserving, totally endoscopic approach is feasible in selected patients, although further experience is needed.
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