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Ann Thorac Surg 2007;84:2138. doi:10.1016/j.athoracsur.2007.07.070
© 2007 The Society of Thoracic Surgeons
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Correspondence

Management of Tricuspid Valve Replacement

Douglas Schuch, MD

Sutter Medical Center, 5041 Jardin Lane, Carmichael, CA 95608

(Email: schuchdc{at}comcast.net).

To the Editor:

I believe that authors Lee and colleagues [1] have tried to complicate a relatively straightforward procedure. They have attempted to develop a method to replace the tricuspid valve "off-pump." They developed this system in their words "to eliminate cardiopulmonary bypass-related lung injury and to preserve right ventricular function" [1]. I do not agree with either of these presumptions. A short course of cardiopulmonary bypass with the beating heart would have essentially no effect on the postoperative right ventricular function. The injury to the lung from the previous procedure was not due to cardiopulmonary bypass, but rather to probable emboli of septic material that was no longer an issue when the authors assumed care of the patient. Therefore, I believe that a simple and well-practiced operation of tricuspid valve replacement on cardiopulmonary bypass without cross clamping was replaced by a more complex procedure with no additional benefit. Without clear and convincing reasons to abandon a procedure of choice with proven techniques, I believe the authors are guilty of trying to "re-invent the wheel." There is a reason that this operation has been done with the proven technique for many years on many patients. Simply put, it works. Simplification in the operating room is what maximizes success. We should always keep this in mind with dealing with critically ill patients.


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  1. Lee KK, Yu HY, Chen YS, Chi NH, Chang CI, Wang SS. Off-pump tricuspid valve replacement for severe infective endocarditis Ann Thorac Surg 2007;84:309-311.[Abstract/Free Full Text]




This Article
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Douglas Schuch
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