A novel technique for correction of severe tricuspid valve regurgitation due to complex lesions

Michele De Bonis, Elisabetta Lapenna, Giovanni La Canna, Antonio Grimaldi, Francesco Maisano, Lucia Torracca, Alessandro Caldarola, Ottavio Alfieri

Research output: Contribution to journalArticle

Abstract

Objectives: Correction of tricuspid regurgitation due to complex lesions (not treatable with annuloplasty only) is associated with suboptimal results. To improve the efficacy of valve repair in this context, we developed a new surgical approach, which consists of stitching together the central part of the free edges of the leaflets producing a 'clover' shaped valve. Our preliminary experience with this novel technique is reported. Methods: Between 2001 and 2003, 14 patients (mean age 57±17 years), with severe tricuspid regurgitation due to complex lesions, underwent valve repair with this novel approach in combination with annuloplasty. The aetiology of the disease was post-traumatic in five cases, degenerative in eight and secondary to dilated cardiomyopathy in one. Anterior leaflet prolapse/flail was present in most patients associated with posterior and/or septal leaflet prolapse or tethering. Annular and right ventricular dilatation was present in all cases. Mitral valve repair/replacement was concomitantly performed in nine patients. Results: Hospital mortality was 7.1% (1/14). At follow-up extending to 22 months (mean 12±6.3), all survivors were asymptomatic. At the last echocardiogram tricuspid regurgitation was absent or mild in 13 patients and moderate in one. Mean tricuspid valve area and gradient were 4.2±0.4 cm2 and 2.7±1.4 mmHg, respectively. Conclusions: Despite the short follow-up, this novel technique appears to be an easy, rapid and effective approach to correct severe tricuspid regurgitation due to complex lesions. Such a repair restored tricuspid valve competence, even in the presence of huge RV dilatation and pulmonary hypertension.

Original languageEnglish
Pages (from-to)760-765
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume25
Issue number5
DOIs
Publication statusPublished - May 2004

Fingerprint

Tricuspid Valve Insufficiency
Tricuspid Valve
Prolapse
Dilatation
Medicago
Dilated Cardiomyopathy
Hospital Mortality
Mitral Valve
Pulmonary Hypertension
Mental Competency
Survivors

Keywords

  • Tricuspid prolapse
  • Tricuspid regurgitation
  • Valve repair

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

A novel technique for correction of severe tricuspid valve regurgitation due to complex lesions. / De Bonis, Michele; Lapenna, Elisabetta; La Canna, Giovanni; Grimaldi, Antonio; Maisano, Francesco; Torracca, Lucia; Caldarola, Alessandro; Alfieri, Ottavio.

In: European Journal of Cardio-thoracic Surgery, Vol. 25, No. 5, 05.2004, p. 760-765.

Research output: Contribution to journalArticle

De Bonis, Michele ; Lapenna, Elisabetta ; La Canna, Giovanni ; Grimaldi, Antonio ; Maisano, Francesco ; Torracca, Lucia ; Caldarola, Alessandro ; Alfieri, Ottavio. / A novel technique for correction of severe tricuspid valve regurgitation due to complex lesions. In: European Journal of Cardio-thoracic Surgery. 2004 ; Vol. 25, No. 5. pp. 760-765.
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AU - De Bonis, Michele

AU - Lapenna, Elisabetta

AU - La Canna, Giovanni

AU - Grimaldi, Antonio

AU - Maisano, Francesco

AU - Torracca, Lucia

AU - Caldarola, Alessandro

AU - Alfieri, Ottavio

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N2 - Objectives: Correction of tricuspid regurgitation due to complex lesions (not treatable with annuloplasty only) is associated with suboptimal results. To improve the efficacy of valve repair in this context, we developed a new surgical approach, which consists of stitching together the central part of the free edges of the leaflets producing a 'clover' shaped valve. Our preliminary experience with this novel technique is reported. Methods: Between 2001 and 2003, 14 patients (mean age 57±17 years), with severe tricuspid regurgitation due to complex lesions, underwent valve repair with this novel approach in combination with annuloplasty. The aetiology of the disease was post-traumatic in five cases, degenerative in eight and secondary to dilated cardiomyopathy in one. Anterior leaflet prolapse/flail was present in most patients associated with posterior and/or septal leaflet prolapse or tethering. Annular and right ventricular dilatation was present in all cases. Mitral valve repair/replacement was concomitantly performed in nine patients. Results: Hospital mortality was 7.1% (1/14). At follow-up extending to 22 months (mean 12±6.3), all survivors were asymptomatic. At the last echocardiogram tricuspid regurgitation was absent or mild in 13 patients and moderate in one. Mean tricuspid valve area and gradient were 4.2±0.4 cm2 and 2.7±1.4 mmHg, respectively. Conclusions: Despite the short follow-up, this novel technique appears to be an easy, rapid and effective approach to correct severe tricuspid regurgitation due to complex lesions. Such a repair restored tricuspid valve competence, even in the presence of huge RV dilatation and pulmonary hypertension.

AB - Objectives: Correction of tricuspid regurgitation due to complex lesions (not treatable with annuloplasty only) is associated with suboptimal results. To improve the efficacy of valve repair in this context, we developed a new surgical approach, which consists of stitching together the central part of the free edges of the leaflets producing a 'clover' shaped valve. Our preliminary experience with this novel technique is reported. Methods: Between 2001 and 2003, 14 patients (mean age 57±17 years), with severe tricuspid regurgitation due to complex lesions, underwent valve repair with this novel approach in combination with annuloplasty. The aetiology of the disease was post-traumatic in five cases, degenerative in eight and secondary to dilated cardiomyopathy in one. Anterior leaflet prolapse/flail was present in most patients associated with posterior and/or septal leaflet prolapse or tethering. Annular and right ventricular dilatation was present in all cases. Mitral valve repair/replacement was concomitantly performed in nine patients. Results: Hospital mortality was 7.1% (1/14). At follow-up extending to 22 months (mean 12±6.3), all survivors were asymptomatic. At the last echocardiogram tricuspid regurgitation was absent or mild in 13 patients and moderate in one. Mean tricuspid valve area and gradient were 4.2±0.4 cm2 and 2.7±1.4 mmHg, respectively. Conclusions: Despite the short follow-up, this novel technique appears to be an easy, rapid and effective approach to correct severe tricuspid regurgitation due to complex lesions. Such a repair restored tricuspid valve competence, even in the presence of huge RV dilatation and pulmonary hypertension.

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