title: The FORGOTTEN (TRICUSPID) VALVE; THIRD TIME, RIGHT TIME.
abstract: Tricuspid regurgitation (TR) remains a challenging condition, the indication, timing and type of surgery for which are not yet well established. A 42-year-old woman was referred to the authors' institution with recurrent, symptomatic TR at one year after she had undergone tricuspid valve repair for an Ebstein's anomaly. At 14 months after the first surgery a bioprosthesis was implanted for a detached annuloplasty ring, and she made a complete recovery. However, at 15 months after valve replacement she presented again with right heart failure and massive TR due to rare early pannus formation. A re-redo tricuspid valve replacement was performed. Tricuspid valve replacement with a bioprosthesis is a valid option if repair is unsuccessful. However, there is a need to be aware of concomitant problems such as a requirement for pacemaker implantation, the risk for prosthesis thrombosis or pannus formation, and the importance of anticoagulation therapy. Annual transthoracic echocardiographic follow up is advisable to exclude subclinical TR.
authors.forename: Kristof
authors.initials: K
authors.lastname: De Brabandere
authors.forename: Bram J
authors.initials: BJ
authors.lastname: Amsel
authors.forename: Inez
authors.initials: I
authors.lastname: Rodrigus
mesh_terms: D000328:Adult; D001705:Bioprosthesis / Q000009:adverse effects; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D011475:Prosthesis Failure; D012086:Reoperation; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*