title: Transfer of the posterior leaflet of the tricuspid valve to the mitral valve.
abstract: OBJECTIVE
  Coverage of large commissural defects may present a surgical challenge in mitral valve repair, for which the transfer of posterior tricuspid valve leaflet tissue is an attractive approach.
  
  
  METHODS
  Five patients aged between 35 and 55 years underwent this procedure. After wide excision of the diseased mitral commissures, the posterior leaflet of the tricuspid valve was carefully checked, removed with its subvalvular apparatus, and transferred to the commissural area of the mitral valve. The stress on the papillary muscle suture was relieved by reinforcement of the free edge of the transferred leaflet by natural or artificial chordae. The tricuspid valve was repaired using either a sliding plasty or an annuloplasty.
  
  
  RESULTS
  One patient who had no reinforcement of the subvalvular apparatus had a papillary muscle rupture and required mitral valve replacement during the early postoperative period. The four remaining patients remained asymptomatic and had no or trivial mitral regurgitation after a median of 13 months (range: 3-18 months), with excellent result at transesophageal echocardiography.
  
  
  CONCLUSIONS
  We conclude that transfer of the tricuspid valve leaflet allows coverage of large commissural defect, and deserves a place among the surgeon's arsenal of reconstructive techniques for mitral valve repair.
authors.affiliation: Cliniques Universitaires St. Luc, Service de Chirurgie Cardiovasculaire et Thoracique, Brussels, Belgium.
authors.forename: G E
authors.initials: GE
authors.lastname: Khoury
authors.forename: Y
authors.initials: Y
authors.lastname: d'Udekem
authors.forename: P
authors.initials: P
authors.lastname: Noirhomme
authors.forename: R
authors.initials: R
authors.lastname: Verhelst
authors.forename: J
authors.initials: J
authors.lastname: Rubay
authors.forename: R
authors.initials: R
authors.lastname: Dion
mesh_terms: D000328:Adult; D002815:Chordae Tendineae / Q000637:transplantation; D004697:Endocarditis, Bacterial / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery*; D011138:Polytetrafluoroethylene; D013537:Sutures; D014261:Tricuspid Valve / Q000601:surgery / Q000637:transplantation*
chemical_list: D011138:Polytetrafluoroethylene