Right ventricular reduction as an adjunct procedure in tricuspid valve repair.
Functional tricuspid regurgitation secondary to mitral valve disease can not be attributed to the dilatation of the tricuspid annulus alone. Furthermore, geometrical changes of the right ventricle lead to tethering of the tricuspid valve leaflets and thereby to an incomplete leaflet coaptation. With this pathologic entity, conventional isolated tricuspid valve annuloplasty will presumably result in significant residual tricuspid regurgitation. The surgical goal should be the reduction of tricuspid annulus dilatation and annihilation of tethering forces on the tricuspid leaflets. In combination with conventional tricuspid valve annuloplasty, right ventricular reduction surgery, as demonstrated, may be effective in reaching these goals and hereby avoiding residual tricuspid regurgitation in this patient population.
Kappert
Utz
U
Department of Cardiac Surgery, Heart Centre Dresden, University of Technology, Dresden, Germany. u.kappert@herzzentrum-dresden.com
Tugtekin
Sems-Malte
SM
Ouda
Ahmed
A
Alexiou
Konstantin
K
Schmeisser
Alexander
A
Schoen
Steffen
S
Matschke
Klaus
K
D000369:Aged, 80 and over; D002311:Cardiomyopathy, Dilated / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D010210:Papillary Muscles / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis; D012008:Recurrence; D013537:Sutures; D014261:Tricuspid Valve / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000601:surgery*