Edge-to-edge repair of congenital familiar tricuspid regurgitation: Case report

We report a case of edge-to-edge (Alfieri's technique) repair of congenital familiar tricuspid regurgitation in a 49-year-old woman, who had severe tr icuspid regurgitation, atrial septal defect with left-to-right shunt, and t wo stenoses in peripheral branches of the left pulmonary artery, of no clin ical relevance. The repair was performed through a longitudinal inferior pa rtial sternotomy. The atrial septal defect. was closed by direct suture; th e anterior and posterior leaflets of the tricuspid valve were sutured toget her. The chordae to the prolapsing medial part of the anterior leaflet were shortened by direct suture to the leaflet free edge. Annuloplasty was perf ormed by means of a Carpentier ring. The final step was edge-to-edge approx imation of the septal leaflet to the new antero-posterior position with two interrupted stitches. The hemodynamic result was excellent, and the patien t eventually returned to full active life.