VALVE REPAIR FOR TRAUMATIC TRICUSPID REGURGITATION

Objective. The review of six cases of valve repair for traumatic tricu spid regurgitation in our institution and 74 in the literature in orde r to assess effective methods of treating this lesion. Methods. Tricus pid valve regurgitation is a rare complication of blunt chest trauma. Optimal treatment for this condition is still controversial ranging fr om long-term medical therapy to early surgical correction. We followed the cases of six consecutive patients with post-traumatic tricuspid i ncompetence who were successfully treated with reparative techniques. All patients were male and their ages ranged from 18 years to 42 years . Valve regurgitation was always secondary to blunt chest trauma due t o motor vehicle accident. The mechanism of valve insufficiency was inv ariably anterior leaflet prolapse due to chordal or papillary muscle r upture associated with annular dilatation. Surgical procedures include d Carpentier ring implant (5 patients), Bex posterior annuloplasty (1 patient), implant of artificial chordae (4 patients), papillary muscle reinsertion (2 patients), commissuroplasty (1 patient) and ''artifici al double orifice'' technique(1 patient). Results. Tricuspid insuffici ency improved in all patients after the correction. No complications w ere recorded and all patients were asymptomatic at the follow-up. Conc lusions. Since post-traumatic tricuspid regurgitation is effectively c orrectable with reparative techniques, early operation is recommended to relieve symptoms and to prevent right ventricular dysfunction.