title: Preservation of systemic tricuspid valve function by pulmonary conduit banding in a patient with corrected transposition of the great arteries.
abstract: Systemic tricuspid valve regurgitation increases mortality and morbidity in patients with a corrected transposition of the great arteries. A 17-year old male with a physiologically corrected transposition after the closure of a ventricular septal defect and conduit placement between a morphological left ventricle and pulmonary artery presented with exertional dyspnoea. The transthoracic echocardiography showed a severe conduit stenosis, and cardiac catheterization revealed a pressure gradient of 114 mmHg. The patient underwent conduit re-replacement using a pulmonary heterograft. Intraoperative transoesophageal echocardiography revealed an acute severe tricuspid regurgitation after a conduit re-replacement. Pulmonary conduit banding was performed under transoesophageal echocardiography guidance, during which the left ventricular to right ventricular pressure ratio increased from 0.33 to 0.60 and the degree of tricuspid regurgitation decreased mildly. The patient was discharged uneventfully at postoperative day 16. Conduit banding might be a useful technique to preserve the systemic tricuspid valve function during conduit re-replacement in patients with a corrected transposition.
authors.affiliation: Department of Cardiovascular Surgery Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. ersinerek@hotmail.com
authors.forename: Ersin
authors.initials: E
authors.lastname: Erek
authors.forename: Burcin
authors.initials: B
authors.lastname: Abud
authors.forename: Kursad
authors.initials: K
authors.lastname: Oz
authors.forename: Alper
authors.initials: A
authors.lastname: Güzeltas
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D058366:Blalock-Taussig Procedure / Q000009:adverse effects*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D000080041:Congenitally Corrected Transposition of the Great Arteries; D020878:Device Removal; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008026:Ligation; D008297:Male; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D014188:Transposition of Great Vessels / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000503:physiopathology*; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D017725:Ventricular Pressure