The postoperative treatment of tricuspid valve surgery

Surgery of the tricuspid valve (TV) in congenital heart disease (CHD) represents a specific issue within the postoperative care of cardiac surgery patients. In paediatric CHD patients, the TV is often involved within complex pathologies and their surgical treatment. Within this context, the TV becomes the systemic atrioventricular valve after Mustard-Senning correction, correction of hypoplastic left ventricle, and in congenitally corrected transposition of the great arteries. Isolated congenital TV regurgitation is a rare condition, characterized by TV regurgitation in absence of traumatic, inflammatory, or infective pathogenesis (Gupta et al. Cardiol Young 21:121-129, 2011). This condition is generally consequent to a structural valve defect, characterized by short and thickened chordae attached to rudimentary papillary muscles or directly to the right ventricular musculature, and fusion of two leaflets leading to a bicuspid valve or thickened and nodular leaflets. The right atrium (RA) and right ventricle (RV) are always dilated. In adult CHD patients, TV regurgitation may result from structural valve disease (Ebstein anomaly [EA]) or annulus dilation secondary to RV dilation or pulmonary hypertension. This chapter will address the main problems that can be faced in the early postoperative treatment after TV repair or replacement in CHD patients.