title: 'Four-leaflet clover repair' of severe tricuspid valve regurgitation due to complex lesions.
abstract: We report the case of a 52-year-old man who was referred to surgery because of severe mitral and tricuspid regurgitation of Barlow's disease. In particular, the tricuspid valve was a 'four-leaflet valve' due to the presence of a small accessory leaflet between the septal and the posterior leaflets. The valve insufficiency was determined by prolapse of all leaflets (in particular of the anterior and posterior ones) associated with annular dilatation. The patient underwent both mitral and tricuspid valve repair. The tricuspid regurgitation was corrected by stitching together the middle point of the free edges of the tricuspid leaflets producing a 'four-leaflet clover-shaped' valve. Surgical and echocardiographic images of the repaired valve are reported.
authors.affiliation: Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy. lapenna.elisabetta@hsr.it
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Lapenna
authors.forename: Michele
authors.initials: M
authors.lastname: De Bonis
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Crescenzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: La Canna
authors.forename: Lucia
authors.initials: L
authors.lastname: Torracca
authors.forename: Antonio
authors.initials: A
authors.lastname: Grimaldi
authors.forename: Ottavio
authors.initials: O
authors.lastname: Alfieri
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*