Edge-to-Edge Tricuspid Valve Repair: An Adjuvant Technique for Residual Tricuspid Regurgitation

Background Tricuspid regurgitation is a very common valve disease. Significant morbidity and mortality is associated with tricuspid valve replacement and tricuspid valve plasty is still a preferred choice. Because of the abnormality of valve and subvalvular apparatus, tricuspid valve plasty is sometimes complicated and associated with suboptimal results. This report deals with our surgical experience in using edge-to-edge valve plasty technique in cases with severe residual tricuspid regurgitation. Methods From April 2001 to November 2004, 15 patients with severe residual tricuspid regurgitation underwent edge-to-edge tricuspid valve plasty. The etiology of tricuspid regurgitation was secondary to rheumatic heart disease in 5 cases, secondary to congenital heart disease in 5 cases, to congenital tricuspid valve dysplasia in 1 case, and to posttraumatic and degenerative disease in 2 cases, respectively. After tricuspid valve repair was performed with traditional methods, severe tricuspid regurgitation was still present. Edge-to-edge tricuspid valve plasty was used in these patients. Results There was 1 hospital death. No or trivial tricuspid regurgitation was found in 6 cases, and mild tricuspid regurgitation was present in 9 cases after operation. The follow-up ranged from 8 to 51 months (median, 25.3). Trivial to mild tricuspid regurgitation was present in 12 cases and mild to moderate tricuspid regurgitation in 2 cases. Conclusions Edge-to-edge tricuspid valve plasty is an effective adjuvant procedure for patients who have severe residual tricuspid regurgitation.