Repair of congenital tricuspid valve abnormalities with artificial chordae tendineae V.Mohan Reddy, MD, Doff B McElhinney, MD, Michael M Brook, MD, Norman.

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Presentation transcript:

Repair of congenital tricuspid valve abnormalities with artificial chordae tendineae V.Mohan Reddy, MD, Doff B McElhinney, MD, Michael M Brook, MD, Norman H Silverman, MD, Paul Stanger, MD, Frank L Hanley, MD The Annals of Thoracic Surgery Volume 66, Issue 1, Pages 172-176 (July 1998) DOI: 10.1016/S0003-4975(98)00351-8

Fig 1 Technique of chordal replacement. A single 4-0 expanded polytetrafluoroethylene suture is attached to the rim of the valve leaflet and the ventricular wall at the level corresponding approximately to the location of the papillary muscle origin, and reinforced at both points with Teflon felt pledgets. The insets indicated by arrows show the detail of leaflet and ventricular wall attachment. The Annals of Thoracic Surgery 1998 66, 172-176DOI: (10.1016/S0003-4975(98)00351-8)

Fig 2 Technique of chordal augmentation. The unrepaired valve, with short chordae, is shown at left. The short chordae are transected and augmented, as indicated by the arrows, with one 2-0 expanded polytetrafluoroethylene suture, which is reinforced at its proximal and distal attachments with 4-0 polypropylene sutures. The Annals of Thoracic Surgery 1998 66, 172-176DOI: (10.1016/S0003-4975(98)00351-8)

Fig 3 Transesophageal echocardiograms performed in the operating room before and after tricuspid valve repair in patient 1. (A) Anterior leaflet of the tricuspid valve (arrow) can be seen prolapsing into the right atrium (RA) during systole. (B) Doppler color flow imaging in the same projection, demonstrating severe tricuspid regurgitation, with the jet directed along the course of the septal leaflet toward the atrial septum. (C) After repair, the tricuspid valve leaflets coapt without prolapse of the anterior leaflet. Doppler color flow imaging demonstrated trivial regurgitation (not shown). (LA = left atrium; LV = left ventricle; RV = right ventricle.) The Annals of Thoracic Surgery 1998 66, 172-176DOI: (10.1016/S0003-4975(98)00351-8)