Tricuspid autograft for repair of a destroyed mitral commissure.
The study evaluated the results of the tricuspid valve autograft technique, consisting of transferring the posterior tricuspid leaflet and subvalvular apparatus towards the mitral valve to reconstruct a destroyed commissure. Twenty patients entered the study. Etiology was degenerative in 12 patients (mean age, 55 +/- 21 years). Nine patients had endocarditis, 8 were rheumatic. Echocardiography results and secondary events were reviewed. Mean follow-up was 44 +/- 17 months. One patient died from sepsis. Survivors were in sinus rhythm. Predischarge echocardiography showed trivial or no mitral regurgitation in all but one patient (mild). Mean transmitral gradients were 3 to 6 mm Hg, and valvular surface was 4.3 +/- 2.1 cm(2). On the tricuspid valve, regurgitation was zero to mild, gradients 4 to 7 mm Hg. One patient developed recurrent endocarditis at 18 months with moderate regurgitation. Results were stable in all the other patients. The tricuspid autograft is an attractive technique for a selected group of patients with commissural destruction. The 6-year results are very encouraging.
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Department of Cardiovascular Surgery, Hopital Bichat, Paris, France.
D000328:Adult; D000368:Aged; D004696:Endocarditis / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000033:anatomy & histology / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000209:etiology / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000601:surgery; D014182:Transplantation, Autologous; D014261:Tricuspid Valve / Q000637:transplantation*