• Journal of Chest Surgery
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• v.31 no.1
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• pp.55-58
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• 1998

Surgical treatment is recommended in tricuspid valve endocarditis not responding to antibiotics or presenting severe heart failure. However, risk of early prosthetic valve endocarditis especially in drug addictors is principal concern in the treatment. A 37 year-old man with tricuspid valve endocarditis underwent staged operation of primary tricuspid valvulectomy and secondary bioprosthetic valve implantation successfully. We report it with references of literature.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.509-512
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• 2009

Ebstein's anomaly is a complex congenital defect of the tricuspid valve and right ventricle. Various surgical methods to repair the regurgitant tricuspid valve have been reported, and most of them depend on monocuspidalization with using the anterior leaflet. We report here on our first experience with Ebstein's anomaly in a 31-year-old female patient who underwent cone reconstruction of the tricuspid valve with using three leaflets.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.376-379
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• 2007

A 51-year-old male was admitted three month previously with a cardiac stab injury and he underwent direct cardiac repair He had no problem after this event. He complained of dyspnea that stalled 2 months after the original injury. Echocardiography showed severe tricuspid regurgitation and so, chordac replacement and ring annuloplasty was performed. Herein we report on a case of tricuspid valve repair for treating tricuspid insufficiency following a cardiac stab injury.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.739-742
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• 2010

Two stents were placed across the right subclavian vein due to stenosis of the right subclavian vein in a 40-year-old patient with chronic renal failure on hemodialysis. During the follow up period, one of stents migrated into the right ventricle inducing tricuspid valve insufficiency. Percutaneous stent removal had failed and the stent was removed by open heart surgery with Tricuspid valve repair with a good result, and then we report the case.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.88-90
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• 2005

Tricuspid annuloplasty with the flexible Duran ring may result in a physiologic repair while maintaining the dynamic morphology of the tricuspid annulus. A method for a durable three-dimensional tricuspid annular reconstruction, which retains the plasticity and orifice area of the tricuspid annulus, is described.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.817-821
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• 2002

There are various surgical techniques in repairing Ebstein anomaly, but residual tricuspid regurgitation and compromized right heart function may ensue in some cases. We report our clinical experience of Ebstein anomaly and atrial flutter in a 19-year-old male patient who underwent simple modified tricuspid annuloplasty, hi-directional cavopulmonary shunt and cryoablation of cavotricuspid isthmus.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.633-637
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• 2003

Sometimes temporary tricuspid valve detachment is applied for closure of ventricular septal defect to facilitate good exposure and avoiding ventriculotomy, but most surgeons hesitate to do it in the fear of tricuspid incompetence. Moreover in recent textbooks the technique of temporary tricuspid detachment is only described for exceptional situations and is not further analysed or commented on. Material and Method: Retrospective study was carried out in all 11 patients operated between 1985 to 1994, with preoperative data and postoperative course and recent echocardiographic and electrocardiographic data. Result: On the basis of the area of the color flow jet, tricuspid valvular regurgitation was graded as none in 9 and trivial in 2, and significant electrocardiographic heart block did not developed in any patients. Conclusion: Takedown and attachment of the tricuspid valve is a safe and effective technique that improves exposure for ventricular septal defect, and does not adversely effect tricuspid valve competence and electrocardiography.

• Journal of Chest Surgery
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• v.38 no.4 s.249
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• pp.284-290
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• 2005

We evaluated the early and mid-term results for repair of Ebstein's anomaly. Material and Method: Between January 1989 and June 2004, 29 patients underwent repair of Ebstein's anomaly. The median age was 11.4 years (4 days-50 years). Tricuspid insufficiency equal to or greater than grade 3 was present in 21 $(72.4\%)$ patients. Surgical techniques included tricuspid valve repair with vertical plication of the atrialized ventricle (n=14), Carpentier's technique (n=7), tricuspid valve replacement (n=4), systemic-to-pulmonary arterial shunt (n=2), tricuspid valve repair (n=1), and Fontan operation (n=1). Bi-directional cavopulmonary shunt (BCPS) was required in 5 patients. Among the 2 neonates, one patient underwent successful biventricular repair, and the other patient underwent systemic-to-pulmonary arterial shunt. Follow-up was possible in 21 patients $(75\%)$, and the average follow-up was 37.6 months (3 months-11.3 years). Result: There were $1(3.4\%)$ early and 1 late deaths. Reoperation was required in 4 patients. Two patients underwent tricuspid valve re-replacement, and the other 2 tricuspid valve repair. At recent follow-up, only 2 patients showed tricuspid insufficiency equal to or greater than grade 3, and most patients showed clinical improvement. Excluding the patients who underwent tricuspid valve replacement, the actuarial rate of freedom from reoperation at 1 and 5 years were $94.7\%\;and\;79.0\%$, respectively. Conclusion: Tricuspid valve repair was possible in most patients with good mid-term outcome. Most patients showed clinical and hemodynamic improvement. Indications for the BCPS should be clarified.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.413-416
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• 2010

A 47-year-old man presented with complaints of chest pain and dyspnea caused by deceleration injury due to an automobile accident. Systolic cardiac murmur was audible at the right sternal border. An electrocardiogram showed sinus tachycardia. Transthoracic echocardiography revealed a flailing anterior leaflet of the tricuspid valve, papillary muscle rupture, and severe valve insufficiency. Rupture of papillary muscle of the anterior leaflet and chordae tendineae of the posterior leaflet were confirmed by right atrial incision under routine cardiopulmonary bypass. Artificial chordae tendineaes were implanted between the anterior and posterior leaflet and papillary muscles in the right ventricles. De-Vega annuloplasty was also added. This is a very rare case in which a surgery was done for tricuspid valve regurgitation caused by post-traumatic papillary muscle rupture.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.28-33
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• 2009

Background: Functional tricuspid regurgitation (TR) greater than or equal to a mild grade requires tricuspid valvuloplasty, and tricuspid valvuloplasty with ring annuloplasty has shown good outcomes. We report here on our early experience with the Edwards $MC^3$ annuloplasty system (Edwards LifeSciences, Irvine, CA). Material and Method: From November 2004 to July 2006, 72 patients with tricuspid annular dilatation and TR underwent tricuspid valvuloplasty with using the Edwards $MC^3$ annuloplasty ring. Sixty-eight patients were operated on via median sternotomy and four patients were operated on using robotic assisted minimal invasive thoracotomy. The patient population included 21 males and 51 females and their mean age was $53.9{\pm}12.3$. The mean grade of TR, as assessed by the preoperative echocardiography, was $2.2{\pm}1.0$. The mean NYHA functional class was $3.1{\pm}0.8$. The mean left ventricular ejection fraction was $57.0{\pm}9.9$%. Result: The TR and NYHA functional class, as assessed by postoperative echocardiography, was significantly reduced (mean=$0.4{\pm}0.6$ and $2.0{\pm}0.7$, respectively p<0.001). There was one case of hospital mortality. One patient required permanent pacemaker insertion for third degree atrioventricular block. Conclusion: Our study shows that the Edwards $MC^3$ remodeling ring is easy to implant and it effectively corrects functional TR with excellent clinical and echocardiographic outcomes. Further follow-up and a larger clinical series are required to establish the long-term stability of this repair technique.