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Thorac Cardiovasc Surg 2018; 66(07): 572-574
DOI: 10.1055/s-0038-1627450
Short Communication
Georg Thieme Verlag KG Stuttgart · New York

Full Orifice Patching without Annuloplasty for Severe Functional Tricuspid Valve Regurgitation

Antonio Maria Calafiore
1   Department of Cardiovascular Diseases, John Paul II Foundation, Campobasso, Italy
,
Carlo Maria De Filippo
1   Department of Cardiovascular Diseases, John Paul II Foundation, Campobasso, Italy
,
Antonio Totaro
1   Department of Cardiovascular Diseases, John Paul II Foundation, Campobasso, Italy
,
Piero Pelini
1   Department of Cardiovascular Diseases, John Paul II Foundation, Campobasso, Italy
,
Michele Di Mauro
1   Department of Cardiovascular Diseases, John Paul II Foundation, Campobasso, Italy
› Author Affiliations
Further Information

Publication History

29 October 2017

29 December 2017

Publication Date:
06 March 2018 (online)

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Abstract

Surgical treatment of severe functional tricuspid regurgitation associated with dilated right ventricle and increased chordal tethering (>8 mm) is challenging. We designed a technique where the anterior and posterior leaflets are detached from 50% of the annulus and a patch as large as the tricuspid orifice is sewn to augment the leaflets' tissue to force the coaptation with the septal leaflet. Annuloplasty is not performed, as it can only increase the chordal tethering, reducing the benefit of tissue augmentation. Early and midterm results in a subgroup of patients with unfavorable anatomical aspects are encouraging.

Keywords

tricuspid valve - echocardiography (all modalities, applications) - tricuspid surgery
 

  • References

  • 1 Navia JL, Nowicki ER, Blackstone EH. , et al. Surgical management of secondary tricuspid valve regurgitation: annulus, commissure, or leaflet procedure?. J Thorac Cardiovasc Surg 2010; 139 (06) 1473-1482.e5
    CrossrefPubMedGoogle Scholar
  • 2 Dreyfus GD, Corbi PJ, Chan KM, Bahrami T. Secondary tricuspid regurgitation or dilatation: which should be the criteria for surgical repair?. Ann Thorac Surg 2005; 79 (01) 127-132
    CrossrefPubMedGoogle Scholar
  • 3 Fukuda S, Gillinov AM, McCarthy PM. , et al. Determinants of recurrent or residual functional tricuspid regurgitation after tricuspid annuloplasty. Circulation 2006; 114 (1, Suppl): I582-I587
    PubMedGoogle Scholar
  • 4 Dreyfus GD, Raja SG, John Chan KM. Tricuspid leaflet augmentation to address severe tethering in functional tricuspid regurgitation. Eur J Cardiothorac Surg 2008; 34 (04) 908-910
    CrossrefPubMedGoogle Scholar
  • 5 Min SY, Song JM, Kim JH. , et al. Geometric changes after tricuspid annuloplasty and predictors of residual tricuspid regurgitation: a real-time three-dimensional echocardiography study. Eur Heart J 2010; 31 (23) 2871-2880
    CrossrefPubMedGoogle Scholar
  • 6 Kara I, Koksal C, Erkin A. , et al. Outcomes of mild to moderate functional tricuspid regurgitation in patients undergoing mitral valve operations: a meta-analysis of 2,488 patients. Ann Thorac Surg 2015; 100 (06) 2398-2407
    CrossrefPubMedGoogle Scholar
  • 7 Choi JB, Kim NY, Kim KH, Kim MH, Jo JK. Tricuspid leaflet augmentation to eliminate residual regurgitation in severe functional tricuspid regurgitation. Ann Thorac Surg 2011; 92 (06) e131-e133
    CrossrefPubMedGoogle Scholar
  • 8 Pettinari M, Bertrand P, Van Kerrebroeck C, Vandervoort P, Gutermann H, Dion R. Mid-term results of leaflet augmentation in severe tricuspid functional tethering. Eur J Cardiothorac Surg 2016; 50 (03) 504-508
    CrossrefPubMedGoogle Scholar
  • 9 Calafiore AM, Refaie R, Iacò AL. , et al. Chordal cutting in ischemic mitral regurgitation: a propensity-matched study. J Thorac Cardiovasc Surg 2014; 148 (01) 41-46
    CrossrefPubMedGoogle Scholar