Document Detail

Tricuspid valve repair for tricuspid valve endocarditis: tricuspid valve "recycling".
MedLine Citation:
PMID:  2012418     Owner:  NLM     Status:  MEDLINE    
Tricuspid valve endocarditis traditionally has been treated with either valve excision or valve replacement. To avoid implantation of foreign material in an infected field, we have applied the principles of mitral valve repair to 4 patients with tricuspid valve endocarditis. On preoperative echocardiography, all patients had 3 to 4+ tricuspid regurgitation, evidence of progressive right ventricular enlargement, and mobile vegetations. In each case, up to three quarters of the anterior leaflet was excised en bloc with infected chordae and papillary muscle heads. Surgical procedures included standard quadrangular resection, conversion to a bicuspid valve, and pericardial patch replacement of the anterior leaflet with mobilization of basal chordae to replace resected marginal chordae. On postoperative echocardiography, tricuspid regurgitation and right ventricular dimensions were reduced in 2 of 4 patients in spite of loss of leaflet tissue. All excised valve tissue demonstrated bacteria on Gram stain or culture. Nonetheless, all repaired valves were successfully sterilized without recurrent infections. Tricuspid valve repair can allow eradication of infection with potential for improving valve competency in complicated tricuspid valve endocarditis.
M D Allen; F Slachman; A C Eddy; D Cohen; C M Otto; A S Pearlman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  51     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-05-07     Completed Date:  1991-05-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  593-8     Citation Subset:  AIM; IM    
Division of Cardiothoracic Surgery, University of Washington, Seattle.
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MeSH Terms
Endocarditis, Bacterial / complications,  microbiology,  surgery*
Follow-Up Studies
Tricuspid Valve / surgery*
Tricuspid Valve Insufficiency / diagnosis,  etiology,  pathology,  surgery*

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