The "clover technique" as a novel approach for correction of post-traumatic tricuspid regurgitation

O. Alfieri, M. De Bonis, E. Lapenna, E. Agricola, A. Quarti, F. Maisano

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: To describe a novel technique, named "clover," to correct complex post-traumatic tricuspid valve lesions. Methods: Five patients with severe post-traumatic tricuspid insufficiency underwent valve reconstruction with the clover technique, a new surgical approach that consists of stitching together the middle point of the free edges of the tricuspid leaflets, producing a clover-shaped valve. The mechanism of tricuspid regurgitation was complex in all patients, and right ventricular function was always moderately to severely depressed. An echocardiographic study was performed after cardiopulmonary bypass, at discharge, and at follow-up. Results: Cardiopulmonary bypass time was 32 ± 6.3 minutes and crossclamp time was 23 ± 7.4. There was no hospital mortality or morbidity. Intraoperative transesophageal and predischarge transthoracic echocardiography showed perfect results in all patients. No late deaths occurred. At the latest follow-up, extending to 14.2 months (mean 11.3; median 12.4), all patients were asymptomatic (New York Heart Association class I) with trivial (2 patients) or no residual regurgitation (3 patients) on 2-dimensional echocardiogram. No transvalvular gradient was revealed in any patient. A significant reduction of the right ventricular end-diastolic dimensions was noted as well (from 54 ± 7.1 mm to 40 ± 7.5 mm, P <.001). Conclusions: In this preliminary experience, the clover technique increased the feasibility of tricuspid valve repair in case of severe traumatic tricuspid valve insufficiency, leading to very satisfactory mid-term results even in the presence of complex lesions or dilatation and deterioration of the right ventricle.

Original languageEnglish
Pages (from-to)75-79
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume126
Issue number1
DOIs
Publication statusPublished - Jul 1 2003

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Medicago
Tricuspid Valve Insufficiency
Tricuspid Valve
Cardiopulmonary Bypass
Right Ventricular Function
Patient Rights
Hospital Mortality
Heart Ventricles
Echocardiography
Dilatation
Morbidity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

The "clover technique" as a novel approach for correction of post-traumatic tricuspid regurgitation. / Alfieri, O.; De Bonis, M.; Lapenna, E.; Agricola, E.; Quarti, A.; Maisano, F.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 1, 01.07.2003, p. 75-79.

Research output: Contribution to journalArticle

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