title: Tricuspid leaflet augmentation to address severe tethering in functional tricuspid regurgitation.
abstract: This paper describes a technique for treating severe tricuspid regurgitation due to severe tethering of the tricuspid valve leaflets. The anterior tricuspid leaflet is augmented by use of an autologous pericardial patch, which increases its size, and hence its surface area of coaptation, allowing increased leaflet coaptation to occur with reduced tension within the right ventricle. A Carpentier-Edwards annuloplasty ring is then implanted. We have successfully performed this operation in 15 patients with severe tricuspid regurgitation due to severe leaflet tethering and have achieved complete elimination of tricuspid regurgitation with good coaptation of the tricuspid leaflets. We describe this simple and easily reproducible technique to treat severe tricuspid regurgitation due to tethering of the tricuspid valve leaflets.
authors.affiliation: Department of Cardiac Surgery, Royal Brompton and Harefield NHS Trust, Harefield Hospital, Hill End Road, Harefield, Middlesex UB96JH, United Kingdom. G.Dreyfus@rbht.nhs.uk
authors.forename: Gilles D
authors.initials: GD
authors.lastname: Dreyfus
authors.forename: Shahzad G
authors.initials: SG
authors.lastname: Raja
authors.forename: Kok Meng
authors.initials: KM
authors.lastname: John Chan
mesh_terms: D000328:Adult; D000368:Aged; D004108:Dilatation, Pathologic / Q000150:complications; D006801:Humans; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation; D014261:Tricuspid Valve / Q000473:pathology / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D055815:Young Adult