PMID- 19231380
OWN - NLM
STAT- MEDLINE
DCOM- 20090320
LR  - 20090223
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 87
IP  - 3
DP  - 2009 Mar
TI  - Valve repair with autologous pericardium for organic lesions in rheumatic 
      tricuspid valve disease.
PG  - 726-30
LID - 10.1016/j.athoracsur.2008.12.005 [doi]
AB  - BACKGROUND: Surgical repair of pathologic tricuspid valve disease often fails 
      because of severe anatomic distortion of the valve apparatus, particularly in 
      patients with rheumatic heart disease. This usually leads to tricuspid valve 
      replacement despite the associated prosthesis-related complications. This study 
      examines our experience of tricuspid valve repair with autologous pericardium for 
      organic rheumatic tricuspid valve disease. METHODS: From 1996 to 2007, 31 
      patients underwent repairs for rheumatic tricuspid valve disease characterized by 
      retracted leaflets and inadequate leaflet area. The patients, aged 14 to 56 
      years, had a mean New York Heart Association (NYHA) class of 2.9 +/- 0.6. All 
      patients presented with severe tricuspid regurgitation and coexisting left-sided 
      heart valve disease. Glutaraldehyde-treated autologous pericardial patch was used 
      to augment tricuspid valve leaflets. Other techniques were applied as needed, 
      including commissurotomy, leaflet mobilization, annuloplasty, and prosthetic ring 
      implantation. Concomitant operations included left-sided valve replacement in 
      all, and left atrial thrombus removal in 3 patients. Follow-up duration was 4 to 
      126 months. RESULTS: No deaths or late reoperations occurred. All patients 
      demonstrated clinical improvements on follow-up. Echocardiographic studies before 
      hospital discharge showed less than mild tricuspid regurgitation in all patients. 
      The most recent echocardiographic follow-up showed no tricuspid regurgitation in 
      10 patients (32.3%), trivial regurgitation in 12 (38.7%), mild regurgitation in 8 
      (25.8%), and moderate regurgitation in 1 (3.2%). CONCLUSIONS: In selected 
      patients, organic rheumatic tricuspid valve disease can be treated with 
      pericardial patch to augment the retracted leaflets in combination with other 
      techniques. Follow-up reveals excellent tricuspid valve function.
FAU - Tang, Hao
AU  - Tang H
AD  - Department of Cardiothoracic Surgery, Changhai Hospital, Shanghai, China.
FAU - Xu, Zhiyun
AU  - Xu Z
FAU - Zou, Liangjian
AU  - Zou L
FAU - Han, Lin
AU  - Han L
FAU - Lu, Fanglin
AU  - Lu F
FAU - Lang, Xilong
AU  - Lang X
FAU - Song, Zhigang
AU  - Song Z
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiac Surgical Procedures/methods
MH  - Female
MH  - Heart Valve Diseases/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pericardium/*transplantation
MH  - Rheumatic Heart Disease/*surgery
MH  - Tricuspid Valve/*surgery
MH  - Young Adult
EDAT- 2009/02/24 09:00
MHDA- 2009/03/21 09:00
CRDT- 2009/02/24 09:00
PHST- 2008/09/16 00:00 [received]
PHST- 2008/11/29 00:00 [revised]
PHST- 2008/12/01 00:00 [accepted]
PHST- 2009/02/24 09:00 [entrez]
PHST- 2009/02/24 09:00 [pubmed]
PHST- 2009/03/21 09:00 [medline]
AID - S0003-4975(08)02547-2 [pii]
AID - 10.1016/j.athoracsur.2008.12.005 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2009 Mar;87(3):726-30. doi: 10.1016/j.athoracsur.2008.12.005.