Tricuspid repair for infective endocarditis - Clinical and echocardiographic results

We report our retrospective experience in The treatment of infective tricus pid endocarditis with valve repair: From January 1981 through January 1999, 238 cases of infective endocarditis were seen at our institution, with tri cuspid involvement in 19 cases. Tricuspid valve repair was performed in 9 p atients whose valves had infective lesions involving a single leaflet. One goal of the repair was to avoid implanting any prosthetic material. At surgery, the posterior leaflet was completely excised and annuloplasty w as performed in 4 patients. Wide quadrangular resection of the anterior lea flet and De Vega annuloplasty were performed in the other 5 patients. All p atients had a good postoperative recovery. Postoperative echocardiography s howed no tricuspid regurgitation in 4 patients, mild regurgitation in 3, an d moderate in 2. Follow-up ranged from 21 to 155 months (mean, 47.56 +/- 50 [SD] months). Two late deaths occurred: one, 2 months postoperatively (sud den death), and he other, 108 months postoperatively (lung carcinoma). late postoperative echocardiography showed no tricuspid regurgitation in 4 pati ents, mild in 2, and moderate in 2. No recurrent infection was observed. Tricuspid valve repair rather than valvulectomy or replacement is indicated in cases of right-sided endocarditis with single-leaflet involvement. Tric uspid repair enables eradication of the infection without implantation of p rosthetic material.