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

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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. © 2004 Elsevier B.V. All rights reserved.




De Bonis, M., Lapenna, E., La Canna, G., Grimaldi, A., Maisano, F., Torracca, L., … Alfieri, O. (2004). A novel technique for correction of severe tricuspid valve regurgitation due to complex lesions. In European Journal of Cardio-thoracic Surgery (Vol. 25, pp. 760–765). https://doi.org/10.1016/j.ejcts.2004.01.051

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