Evaluation of Segmental Trtricuspid Annulopfasty, a New Technique for Tricuspid pair

Abstract

Acquired tricuspid valve (Tr.V.) disease is classified surgically as functional or organic (Karp, 1990).

The most common cause of tricuspid regurgitation (T.R.) is not intrinsic involvement of the valve itself, but dilatation of the right ventricle (R V.) and of the tricuspid anulus, which may be due to complication or right ventricular failure of any cause. This results in failure of systolic valve coaptation of the tricuspid valve leaflets (Braunwald, 1992).

The degree of functional impairement is related to the severity of the left sided lesion, the duration of aortic or mitral valve (M.V.) dysfunction and the resultant degree of pulmonary artery hypertension and the degree of right ventricular dilatation (Karp, 1990).

In tricuspid insufficiency 'the systolic regurgitation into the right atrium elevates the right atrial (R.A) pressure (Rackley et al., 1990a). I Hepatic dysfunction often complicates Tr.V. disease and must be defined

before surgical intervention (Karp, 1990).

T.R. in the ·absence of pulmonary hypertension (PH+) usually does not require.surgical treatment. In patients with PH+, the severity of regurgitation should be assessed by palpation of the valve at the time of the mitral or aortic valve surgery. Excellent results have been reported in patients with T.R. with the use of the De-Vega tricuspid annuloplasty (Braunwald, 1992).