Chordae Tendineae Approximation Technique for Severe Tricuspid Regurgitation with Severe Leaflet Tethering Using a Totally Endoscopic Beating-Heart Strategy: A Case Report
Untreated severe tricuspid regurgitation (TR) is associated with poor outcomes. Functional TR occurs secondary to dilatation of the annulus and tethering of the leaflets. Ring annuloplasty alone can correct most cases, but is insufficient in cases of severe annular dilatation due to severe leafle...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2023-01-01
|
| Series: | Journal of Chest Surgery |
| Subjects: |
| Summary: | Untreated severe tricuspid regurgitation (TR) is associated with poor outcomes. Functional
TR occurs secondary to dilatation of the annulus and tethering of the leaflets. Ring annuloplasty
alone can correct most cases, but is insufficient in cases of severe annular dilatation
due to severe leaflet tethering. In such cases, a tricuspid edge-to-edge technique may
be an option. However, stitching of the leaflet tips alone is likely to result in tearing of the
leaflets. Approximation of the durable chordae tendineae is considered helpful for this
problem. Herein, we present the case of a 39-year-old man who had undergone openheart
surgery for acute type A aortic dissection 13 months earlier. A right mini-thoracotomy
approach with a beating-heart strategy was used, which did not require unnecessary
pericardial adhesiolysis and dissection. This technique had the advantage of reducing the
operation time and the risk of bleeding. To summarize, we present a case of tricuspid valve
repair in a high-risk patient with severe leaflet tethering that was successfully managed
using these methods. |
|---|---|
| ISSN: | 2765-1606 2765-1614 |