Valve repair for traumatic tricuspid regurgitation

Abstract

OBJECTIVE: The review of six cases of valve repair for traumatictricuspid regurgitation in our institution and 74 in the literature inorder to assess effective methods of treating this lesion. METHODS:Tricuspid valve regurgitation is a rare complication of blunt chest trauma.Optimal treatment for this condition is still controversial ranging fromlong-term medical therapy to early surgical correction. We followed thecases of six consecutive patients with post-traumatic tricuspidincompetence who were successfully treated with reparative techniques. Allpatients were male and their ages ranged from 18 years to 42 years. Valveregurgitation was always secondary to blunt chest trauma due to motorvehicle accident. The mechanism of valve insufficiency was invariablyanterior leaflet prolapse due to chordal or papillary muscle ruptureassociated with annular dilatation. Surgical procedures included Carpentierring implant (5 patients), Bex posterior annuloplasty (1 patient), implantof artificial chordae (4 patients), papillary muscle reinsertion (2patients), commissuroplasty (1 patient) and "artificial double orifice"technique (1 patient). RESULTS: Tricuspid insufficiency improved in allpatients after the correction. No complications were recorded and allpatients were asymptomatic at the follow-up. CONCLUSIONS: Sincepost-traumatic tricuspid regurgitation is effectively correctable withreparative techniques, early operation is recommended to relieve symptomsand to prevent right ventricular dysfunction.