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Case Reports

Right Ventricular Plication in a Neonate With an Unguarded Tricuspid Valvar Orifice

^a Department of Cardiovascular Surgery, Japanese Red Cross Medical Center Tokyo, Japan
^b Department of Neonatology, Japanese Red Cross Medical Center Tokyo, Japan
^c Department of Pediatrics, Japanese Red Cross Medical Center Tokyo, Japan
^d Cardiac Unit, Institute of Child Health, University College of London, London, United Kingdom

Accepted for publication June 4, 2008.

^_* Address correspondence to Dr Kaneko, Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan (Email: yukihirokaneko{at}hotmail.com).

Unguarded tricuspid orifice is a congenital cardiac malformation characterized by absence of the tricuspid valvar leaflets in the setting of a normal atrioventricular junction and obligatory severe tricuspid regurgitation. A neonate with such a lesion presented with severe cardiac failure. The right atrium and ventricle were grossly dilated, and there were small muscular ventricular septal defects. We plicated the right-sided structures to create space for adequate expansion of the lungs and left ventricular filling, proceeding to staged conversion to the Fontan circulation. Our experience shows that neonates with cardiac failure due to dilated right-sided structures can be stabilized by surgical plication.