Surgical management of isolated congenital tricuspid regurgitation

Background. Isolated congenital tricuspid regurgitation without downward di splacement of the leaflet is a rare clinical entity. Degenerative cusps and lack of chordae may preclude valvuloplasty and require valve replacement. Methods. Three consecutive patients with isolated congenital tricuspid regu rgitation underwent surgical repair between May 1995 and April 1997 Their a ges were 23, 15, and 8 years old, Tricuspid Valvuloplasty was feasible in a ll of them, with use of a gathering suture of the anterior leaflet, artific ial chordae implantation, and ring annuloplasty. Results. All 3 patients survived and recovered well after the operation. Th e cardiothoracic ratios on their chest roentgenograms decreased from 0.64 t o 0.52 in patient 1, from 0.58 to 0.48 in patient 2, and from 0.60 to 0.44 in patient 3. Postoperative echocardiograms showed competent tricuspid valv es and the disappearance of regurgitation in all cases. Conclusions. Although malformation of the valve is extensive in isolated co ngenital tricuspid regurgitation, application of artificial chordae with co nventional valvuloplasty technique can avoid the use of prosthetic valves b y establishing the competence of the tricuspid valve. (C) 1998 by The Socie ty of Thoracic Surgeons.