PMID- 17661778
OWN - NLM
STAT- MEDLINE
DCOM- 20070917
LR  - 20161124
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 22
IP  - 4
DP  - 2007 Jul-Aug
TI  - Repair of flail leaflet of the tricuspid valve by a simple cusp remodeling 
      technique.
PG  - 333-5
AB  - BACKGROUND AND AIM: The approach of repairing tricuspid valve insufficiency 
      caused by congenital lack of chordae or traumatic rupture of chordae is often 
      complicated and difficult. We try to present an alternative method and midterm 
      results. METHODS: Between April 1997 and December 2004, eight patients (5 males, 
      3 females; mean age 23.9 +/- 5.8 years; range: 8 to 57 years) with severe 
      tricuspid regurgitation (congenital lack of chordae in 5 cases and traumatic 
      rupture of chordae in 3 cases) underwent surgical repair at Fu Wai Hospital. Four 
      patients were in NYHA (New York Heart Association) class III, and 4 in class IV. 
      Eight flail anterior leaflets and one flail septal leaflet of the tricuspid valve 
      with massive tricuspid regurgitation were identified by echocardiography and the 
      spaces of the free edges of the flail leaflets ranged from 20 to 30 mm. Tricuspid 
      repair was performed under hypothermic cardiopulmonary bypass. The free edge of 
      the affected cusp segment was sutured in folio, the segment of annulus devoid of 
      leaflet was plicated, and the neo-annulus was fixed with a flexible annuloplasty 
      ring. RESULTS: All patients survived and recovered after the operation. 
      Echocardiography showed good coaptation with no regurgitation of the tricuspid 
      valve in five patients and a mild residual tricuspid regurgitation in three 
      patients. A remarkable decrease in the diameter of the right ventricle was 
      observed, from a mean of 42.6 +/- 12.5 mm to a mean of 23.6 +/- 5.3mm (p < 0.01). 
      Mean follow up was 50 +/- 42.9 months. Six patients were in NYHA class I, and two 
      in class II and III. Except for one patient who had a mild-to-moderate increase 
      in tricuspid regurgitation a year later, all the other patients were doing well. 
      CONCLUSION: The procedure provided a simple and valuable option for repair of 
      flail leaflet of tricuspid valve caused by congenital lack of chordae or 
      traumatic rupture of chordae.
FAU - Yang, Xiubin
AU  - Yang X
AD  - Department of Cardiovascular Surgery, Cardiovascular Institute and Fu Wai 
      Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing, People's Republic China. xiubinyang@yahoo.com
FAU - Wu, Qingyu
AU  - Wu Q
FAU - Xu, Jianping
AU  - Xu J
FAU - Shen, Xiangdong
AU  - Shen X
FAU - Gao, Shuang
AU  - Gao S
FAU - Liu, Feng
AU  - Liu F
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiopulmonary Bypass
MH  - Child
MH  - Chordae Tendineae/abnormalities/injuries
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/diagnostic imaging/surgery
MH  - Humans
MH  - Hypertrophy, Right Ventricular/diagnostic imaging/surgery
MH  - Hypothermia, Induced
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/diagnostic imaging
MH  - Recurrence
MH  - Suture Techniques
MH  - Tricuspid Valve/*abnormalities/diagnostic imaging/*surgery
MH  - Tricuspid Valve Insufficiency/*congenital/diagnostic imaging/*surgery
EDAT- 2007/07/31 09:00
MHDA- 2007/09/18 09:00
CRDT- 2007/07/31 09:00
PHST- 2007/07/31 09:00 [pubmed]
PHST- 2007/09/18 09:00 [medline]
PHST- 2007/07/31 09:00 [entrez]
AID - JCS418 [pii]
AID - 10.1111/j.1540-8191.2007.00418.x [doi]
PST - ppublish
SO  - J Card Surg. 2007 Jul-Aug;22(4):333-5. doi: 10.1111/j.1540-8191.2007.00418.x.