Skip to main content

Tricuspid Valve Surgery

  • Chapter
  • First Online:
  • 226 Accesses

Abstract

Multiple entities affect the tricuspid leaflets, annulus, chordae and papillary muscles and can cause severe tricuspid regurgitation or stenosis in the initial absence of either pulmonary hypertension or right ventricular dysfunction. Over time, these entities can cause progressive right atrial, right ventricular, and annular dilatation, sometimes with atrial fibrillation. In developed countries the most common tricuspid pathology is regurgitation, while tricuspid stenosis is extremely rare. Tricuspid regurgitation is most often functional. The surgical treatment of isolated and concomitant tricuspid valve disease, especially functional tricuspid regurgitation, remains controversial. Functional tricuspid regurgitation may be classified into defined stages, and surgical treatment may be tailored to the extent of the disease. This chapter describes current surgical techniques for tricuspid valve surgery and their results.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Rogers JH, Bolling SF. The tricuspid valve: current perspective and evolving management of tricuspid regurgitation. Circulation. 2009;119:2718–25.

    Article  Google Scholar 

  2. McCarthy PM. Evolving approaches to tricuspid valve surgery. J Am Coll Cardiol. 2015;65:1939–40.

    Article  Google Scholar 

  3. Nath J, Foster E, Heidenreich PA. Impact of tricuspid regurgitation on long-term survival. J Am Coll Cardiol. 2004;43:405–9.

    Article  Google Scholar 

  4. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lansac E, Rodriguez Muñoz D, Rosenhek R, Sjögren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Zamorano JL, ESC Scientific Document Group, Roffi M, Alfieri O, Ahlsson A, Barbato E, Collet J-P, Coman IM, Czerny M, Delgado V, Folliguet T, Gaemperli O, Habib G, Harringer W, Haude M, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2017;38:2739–2791.

    Google Scholar 

  5. Raja SG, Dreyfus GD. Surgery for functional tricuspid regurgitation: current techniques, outcomes and emerging concepts. Expert Rev Cardiovasc Ther. 2009;7:73–84.

    Article  Google Scholar 

  6. Dreyfus GD, Martin RP, Chan KMJ, Dulguerov F, Alexandrescu C. Functional tricuspid regurgitation. J Am Coll Cardiol. 2015;65:2331–6.

    Article  Google Scholar 

  7. Wagner R, Daehnert I, Lurz P. Percutaneous pulmonary and tricuspid valve implantations: an update. World J Cardiol. 2015;7:167–77.

    Article  Google Scholar 

  8. Taramasso M, Alessandrini H, Latib A, Asami M, Attinger-Toller A, Biasco L, Braun D, Brochet E, Connelly KA, Denti P, Deuschl F, Englmeier A, Fam N, Frerker C, Hausleiter J, Himbert D, Ho E, Juliard J-M, Kaple R, Kreidel F, Kuck K-H, Ancona M, Lauten A, Lurz P, Mehr M, Nazif T, Nickening G, Pedrazzini G, Pozzoli A, Praz F, et al. Outcomes after current transcatheter tricuspid valve intervention. JACC Cardiovasc Interv. 2018.

    Google Scholar 

  9. Antunes MJ, Girdwood RW. Tricuspid annuloplasty: a modified technique. Ann Thorac Surg. 1983;35:676–8.

    Article  CAS  Google Scholar 

  10. Sarraj A, Duarte J. Adjustable segmental tricuspid annuloplasty: a new modified technique. Ann Thorac Surg. 2007;83:698–9.

    Article  Google Scholar 

  11. De Bonis M, Lapenna E, La Canna G, Grimaldi A, Maisano F, Torracca L, Caldarola A, Alfieri O. A novel technique for correction of severe tricuspid valve regurgitation due to complex lesions. Eur J Cardiothorac Surg. 2004;25:760–5.

    Article  Google Scholar 

  12. Dreyfus GD, Raja SG, John Chan KM. Tricuspid leaflet augmentation to address severe tethering in functional tricuspid regurgitation. Eur J Cardiothorac Surg. 2008;34:908–10.

    Article  Google Scholar 

  13. Dreyfus GD, Chan KMJ. Functional tricuspid regurgitation: a more complex entity than it appears. Heart. 2009;95:868–9.

    Article  Google Scholar 

  14. Ghanta RK, Chen R, Narayanasamy N, McGurk S, Lipsitz S, Chen FY, Cohn LH. Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation: midterm results of 237 consecutive patients. J Thorac Cardiovasc Surg. 2007;133:117–26.

    Article  Google Scholar 

  15. Chang BC, Lim SH, Yi G, Hong YS, Lee S, Yoo KJ, Kang MS, Cho BK. Long-term clinical results of tricuspid valve replacement. Ann Thorac Surg. 2006;81:1317–23.

    Article  Google Scholar 

  16. Gerdisch MW, Boyd WD, Harlan JL, Richardson JB Jr, Flack JE III, Palafox BA, Johnson WE III, Sun B, LEE R, Guy TS, Gang GI, Cox JL, Rao V. Early experience treating tricuspid valve endocarditis with a novel extracellular matrix cylinder reconstruction. J Thorac Cardiovasc Surg. 2014;148:3042–8.

    Article  Google Scholar 

  17. Stephens EH, Borger MA. “Forgotten” valve or “enigmatic” valve? Further insights into the tricuspid valve in patients undergoing mitral valve surgery. J Thorac Cardiovasc Surg. 2014;148:1962–4.

    Article  Google Scholar 

  18. Di Mauro M, Bivona A, Iacò AL, Contini M, Gagliardi M, Varone E, Gallina S, Calafiore AM. Mitral valve surgery for functional mitral regurgitation: prognostic role of tricuspid regurgitation. Eur J Cardiothorac Surg. 2009;35:635–40.

    Article  Google Scholar 

  19. Ruel M, Rubens FD, Masters RG, Pipe AL, Bédard P, Mesana TG. Late incidence and predictors of persistent or recurrent heart failure in patients with mitral prosthetic valves. J Thorac Cardiovasc Surg. 2004;128:278–83.

    Article  Google Scholar 

  20. Dreyfus GD, Corbi PJ, Chan KMJ, Bahrami T. Secondary tricuspid regurgitation or dilatation: which should be the criteria for surgical repair? Ann Thorac Surg. 2005;79:127–32.

    Article  Google Scholar 

  21. Parolari A, Barili F, Pilozzi A, Pacini D. Ring or suture annuloplasty for tricuspid regurgitation? A meta-analysis review. Ann Thorac Surg. 2014;98:2255–63.

    Article  Google Scholar 

  22. Ren WJ, Zhang BG, Liu JS, Qian YJ, Guo YQ. Outcomes of tricuspid annuloplasty with and without prosthetic rings: a retrospective follow-up study. J Cardiothorac Surg. 2015;10:81.

    Article  Google Scholar 

  23. Baraki H, Saito S, Al Ahmad A, Fleischer B, Haverich A, Kutschka I. Beating heart versus arrested heart isolated tricuspid valve surgery. Int Heart J. 2015;56:400–7.

    Article  CAS  Google Scholar 

  24. McCarthy PM, Bhudia SK, Rajeswaran J, Hoercher KJ, Lytle BW, Cosgrove DM, Blackstone EH. Tricuspid valve repair: durability and risk factors for failure. J Thorac Cardiovasc Surg. 2004;127:674–85.

    Article  Google Scholar 

Download references

Acknowledgment

Conflict of Interest Statement: The authors declare no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christoph T. Starck .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Starck, C.T., Falk, V. (2020). Tricuspid Valve Surgery. In: Raja, S. (eds) Cardiac Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-24174-2_45

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-24174-2_45

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24173-5

  • Online ISBN: 978-3-030-24174-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics