TRICUSPID AUTOGRAFT FOR MITRAL-VALVE REPAIR

Background Transferring the posterior leaflet of the patient's own tri cuspid Valve with its subvalvular apparatus to the mitral valve is a n ew technique that allows a conservative approach to mitral-valve repai r. The technique is based on the knowledge that the tricuspid valve ca n be remodelled from tricuspid to bicuspid, with a very low risk of si gnificant dysfunction. Methods We describe six patients (age range 20- 70 years) with mitral insufficiency in whom we have used the technique . Findings All patients survived the operation and were in sinus rhyth m. Transoesophageal echocardiography before discharge showed trivial o r no regurgitation at the site of mitral repair. Before operation, all patients were in New York Heart Association class Ill-IV; at follow-u p after 6-13 months all patients were in class I-II Interpretation Com pared with using segments of mitral homografts in similar situations, the intraoperative availability of the tricuspid's viable natural chor dae and valvular leaflet means that there are no immunological disadva ntages to the procedure. With this new operation, the patient is his o wn tissue bank.