Chordae Tendineae Approximation Technique for Severe Tricuspid Regurgitation with Severe Leaflet Tethering Using a Totally Endoscopic Beating-Heart Strategy: A Case Report.
Dong Hee JangJae Suk YooPublished in: Journal of chest surgery (2022)
Untreated severe tricuspid regurgitation (TR) is associated with poor outcomes. Functional TR occurs secondary to dilatation of the annulus and tethering of the leaflets. Ring annuloplasty alone can correct most cases, but is insufficient in cases of severe annular dilatation due to severe leaflet tethering. In such cases, a tricuspid edge-to-edge technique may be an option. However, stitching of the leaflet tips alone is likely to result in tearing of the leaflets. Approximation of the durable chordae tendineae is considered helpful for this problem. Herein, we present the case of a 39-year-old man who had undergone openheart surgery for acute type A aortic dissection 13 months earlier. A right mini-thoracotomy approach with a beating-heart strategy was used, which did not require unnecessary pericardial adhesiolysis and dissection. This technique had the advantage of reducing the operation time and the risk of bleeding. To summarize, we present a case of tricuspid valve repair in a high-risk patient with severe leaflet tethering that was successfully managed using these methods.
Keyphrases
- mitral valve
- aortic valve
- aortic stenosis
- transcatheter aortic valve replacement
- aortic valve replacement
- transcatheter aortic valve implantation
- early onset
- left ventricular
- aortic dissection
- drug induced
- atrial fibrillation
- minimally invasive
- coronary artery disease
- metabolic syndrome
- skeletal muscle
- type diabetes
- ultrasound guided
- hepatitis b virus
- adipose tissue
- acute respiratory distress syndrome
- respiratory failure