title: Surgery for Congenital Tricuspid Valve Cleft: Tricuspid Valve Repair with Neochordae and Annuloplasty.
abstract: OBJECTIVE
  Congenital abnormalities of the tricuspid valve (TV), including dysplasia, straddling, and those associated with other congenital heart disease, are rare causes of tricuspid regurgitation (TR). In congenital TV anomalies there can be varying levels of abnormalities of leaflet and subvalvular structures. Herein is reported a case of TV cleft with absent chordae, and a technique of TV repair.
  
  
  METHODS
  A 14-year-old boy was found to have severe TR due to dysplasia of the anterior TV leaflet. Intraoperatively he was noted to have dysplasia of the TV with a cleft in the anterior leaflet of the TV and an absence of chordae supporting the anterior two-thirds of the anterior leaflet. The anterior papillary muscle was hypoplastic, with chordae to the posterior leaflet and small chordae partly to the anterior leaflet. The cleft was repaired and a neochordae placed onto the anterior leaflet with attachment to the papillary muscle, followed by an annuloplasty.
  
  
  RESULTS
  Intraoperative and postoperative echocardiographic assessment showed good mobility of the anterior tricuspid leaflet at six months and two-year follow up.
  
  
  CONCLUSIONS
  Chordal replacement is a useful technique for repairing congenital dysplastic TV with absent chordae. The same technique for mitral valve repair with neochordae can be applied to chordal anomalies of the TV, with excellent outcome.
authors.forename: Siva Prasad
authors.initials: SP
authors.lastname: Veerbhadran
authors.forename: Vivek Velayudhan
authors.initials: VV
authors.lastname: Pillai
authors.forename: Bijulal
authors.initials: B
authors.lastname: Sasidharan
authors.forename: Jayakumar
authors.initials: J
authors.lastname: Karunakaran
mesh_terms: D000293:Adolescent; D058385:Cardiac Valve Annuloplasty / Q000295:instrumentation*; D002815:Chordae Tendineae / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*