Surgical Techniques of Tricuspid Valve Repair in Patients Without Ebstein Malformation

Repairing the tricuspid valve in congenital heart diseases other than Ebstein’s

“…8,9 The right ventricle is dilated, resulting in right heart failure and tricuspid valve insufficiency, and the majority of patients present in infancy, as survival into adulthood is rare without intervention (Fig 4). 5,[9][10][11][12][13][14] Antegrade flow to the pulmonary arteries depends on right atrial contraction and paradoxical septal motion. 12 Surgical options include conversion to single-ventricular physiology and/or cardiac transplantation if the single-ventricle strategy fails.…”

“…There was significant tricuspid regurgitation with developed pressure in the right ventricle, which allowed tricuspid annuloplasty and pulsatile pulmonary artery flow. 5 Dodge-Khatami et al: Non-Ebstein tricuspid valve repair ventricular exclusion have resulted in patient survival, albeit still ending in eventual cardiac transplant candidacy. 9,12 Rarely, some degree of right ventricular function may be recruited for cardiac output, justifying an attempt at tricuspid annuloplasty to provide antegrade pulmonary flow (Fig 5), 5 before reverting to Fontan physiology, as has successfully been achieved by the senior author.…”

“…32,33 Valve replacement or valvesparing techniques, concomitant to mitral and aortic valve surgery, such as a combination of edge-to-edge Alfieri repair with chordal plasty 32 have led to satisfactory results continuing through mid-term follow-up (Fig 8). 5,34,35 To the best of our knowledge, isolated surgery for tricuspid valve disease in Marfan's disease has not yet been described in the literature, and indication remains uncertain.…”

“…41,48 The anterior and septal leaflets are brought together by placing a partial annuloplasty purse string suture, thereby compressing the posterior leaflet and forcing leaflet coaptation of a neo-bicuspidised valve (Figs 12, 13). 5,48 Depending on the general condition of the patient and eventual superimposed haemodynamic and structural burdens on the heart after repaired tetralogy of Fallot, such as right ventricular dilatation and/ or right outflow pathology, the risk for reoperation and the result of tricuspid valve repair will vary widely, ranging from a very safe procedure with an excellent result, or a very high-risk procedure (up to 16.7% reported mortality) and unstable valve Figure 13. On the left, the poor coaptation of the anterior and septal leaflets are noted and evaluated for the purpose of suture repair by leaflet apposition.…”

“…Copyright © 2014, with permission from Springer. 5 repair. 30,31,41,46,47 Follow-up data on the results and durability of tricuspid valve repair after complete correction of tetralogy of Fallot are scarce, 30,31,47 and it is difficult to evaluate whether the indication is for isolated surgery on the tricuspid valve or other cardiac structures.…”