Video-assisted tricuspid valve surgery: a new surgical option in endocarditis on pacemaker

A patient presenting with a pacemaker lead infection and tricuspid regurgit ation underwent a minimally invasive video-assisted tricuspid valve replace ment. The valve was approached through a right anterior mini thoracotomy. U nder thoracoscopic Vision and peripheral cardiopulmonary bypass, a catheter was placed on the ascending aorta for antegrade cardioplegia delivery. A t ransthoracic aortic crossclamp was introduced through the third right inter costal space. Tricuspid Valve replacement added to the pacemaker leads abla tion was exclusively performed under thoracoscopic vision, providing an exc ellent video-image in this reduced operative field. After 22 months of foll ow up, the patient is asymptomatic, the echocardiography showing a normally functioning valve. (C) 1999 Elsevier Science B.V. All rights reserved.