[Simple surgical method for intraoperative evaluation of adequacy of tricuspid annuloplasty].
In tricuspid annuloplasty intraoperative "real time" evaluation using transoesophageal echocardiography requires normal flow to get reliable result. It means that the patient has to be already weaned from the cardiopulmonary bypass by the time of evaluation. In the authors' experience a well functioning tricuspid annuloplasty prevents back-flow through the valve. It can be observed on on-pump beating heart. If the tricuspid valve is competent, it is unnecessary to suck the blood flowing back through the coronary sinus while closing the right atrium. This observation seems to correlate well with post cardiopulmonary bypass transoesophageal echocardiography measurements and the control transthoracic echocardiography right before discharging the patients. These statements are based on a group of 72 patients. Sixty-nine patients (95.8%) were discharged (early mortality 4.2%). Only in one case we could observe a discrepancy between the intraoperative surgical observation and the postoperative echocardiographic finding. Development of functional tricuspid regurgitation in left-sided heart disease is a warning sign for myocardial impairment, which is an indication for surgery. Tricuspid annuloplasty can be performed even with moderate to medium grade regurgitation because it improves the early and late outcome. The described method is an adequate method for intraoperative evaluation of the repaired tricuspid valve competency.
Tamás
Eva
E
Linköpingi Egyetemi Kórház, Szív- és Mellkassebészeti Klinika, Linköping, Svédország.
Galajda
Zoltán
Z
Maros
Tamás
T
Szentkirályi
István
I
Palotás
Lehel
L
Jagamos
Endre
E
Péterffy
Arpád
A
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*