Partial tricuspid valve transfer for repair of mitral insufficiency due toruptured chordae tendineae

Background. A new technique is suggested for the reconstructive surgical tr eatment of mitral regurgitation. It involves partial transfer of the tricus pid valve of the patient to the mitral valve, in order to provide chordae t o correct anterior leaflet prolapse of the mitral valve, secondary to ruptu re of the chordae tendineae. Methods. From January 1991 to May 1997, 20 patients with mitral insufficien cy due to rupture of the chordae were operated on. The prevailing cause was myxomatous degeneration (70%). Patients were in New York Heart Association functional class III and IV. Results. There were no hospital deaths. Two patients were reoperated on. Ei ghteen patients (90%) are alive with their own valves (class I and II). Dop pler echocardiogram mean values were: ejection fraction, 0.65; left atrial diameter, 4.2 cm; mitral area, 2.4 cm(2); mitral transvalvular gradient, 3. 3 mm Hg. No regurgitation or mild regurgitation was observed in 16 (94.1%) of the 17 cases evaluated. Mean tricuspid valvular area was 3.3 cm(2). In a ll cases, no tricuspid regurgitation was present or it was mild. Conclusions. Partial transfer of the tricuspid valve to the mitral valve is an effective procedure for the surgical treatment of mitral valve insuffie ncy secondary to ruptured chordae tendineae of the anterior leaflet. (C) 19 99 by The Society of Thoracic Surgeons.