A role of valvuloplasty in surgical treatment of isolated tricuspid regurgitation
Sekiguchi, A.; Matsunaga, H.; Kotsuka, Y.; Yagyu, K.; Mathison, M.; Morizuki, O.; Ono, M.; Furuse, A.
Kyobu Geka. Japanese Journal of Thoracic Surgery 46(9): 751-755
1993
ISSN/ISBN: 0021-5252 PMID: 8361098 Document Number: 6078
Seven surgical cases of isolated tricuspid regurgitation were reviewed. From pathological point of view, the patients were classified into three groups. Two were due to abnormalities of subvalvular system, four to annular dilatation and one to anomalous leaflet. Among four cases of annular dilatation, two were diagnosed as dilated cardiomyopathy. In one, it was very rare myopathy confined to right ventricle. Three cases, two subvalvular and one leaflet abnormalities, underwent valvuloplasty which included chordal reconstruction using Gore-Tex suture. Among annular dilatation group, three underwent valve replacement (two with mechanical valve and one with bioprosthetic valve), while fourth underwent annuloplasty. When We look at 89 surgical patients with secondary tricuspid regurgitation, thrombosed mechanical valve was seen in two cases, one of them necessitating re-valve replacement. On the other hand, late results of tricuspid annuloplasty with Carpentier-Edwards ring was excellent without re-operation. Although isolated tricuspid regurgitation has very complicated pathological features, we now think it very important to manage to repair regurgitant tricuspid valve utilizing all available techniques including redundant valve tissue resection, chordal reconstruction, and annuloplasty, thus avoiding valve replacement especially with mechanical valve.
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