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Right Ventricular Reduction as an Adjunct Procedure in Tricuspid Valve Repair

^a Department of Cardiac Surgery, Heart Centre Dresden, University of Technology, Dresden, Germany
^b Department of Cardiology, Heart Centre Dresden, University of Technology, Dresden, Germany

Accepted for publication January 28, 2008.

^_* Address correspondence to Dr Kappert, Heart Centre, University of Technology Dresden Cardiac Surgery, Fetscherstrasse 76, Dresden, D-01307, Germany (Email: u.kappert{at}herzzentrum-dresden.com).

Functional tricuspid regurgitation secondary to mitral valve disease can not be attributed to the dilatation of the tricuspid annulus alone. Furthermore, geometrical changes of the right ventricle lead to tethering of the tricuspid valve leaflets and thereby to an incomplete leaflet coaptation. With this pathologic entity, conventional isolated tricuspid valve annuloplasty will presumably result in significant residual tricuspid regurgitation. The surgical goal should be the reduction of tricuspid annulus dilatation and annihilation of tethering forces on the tricuspid leaflets. In combination with conventional tricuspid valve annuloplasty, right ventricular reduction surgery, as demonstrated, may be effective in reaching these goals and hereby avoiding residual tricuspid regurgitation in this patient population.