Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany.
Interact Cardiovasc Thorac Surg. 2021 Oct 4;33(4):525-526. doi: 10.1093/icvts/ivab134.
Annular dilatation is the main mechanism for tricuspid regurgitation, but right ventricular dilatation often adds a restrictive mechanism, which may limit durability. We describe a subvalvular technique anchoring the chordal origins to the annuloplasty, with the aim to stabilize valve geometry and increase durability. A Goretex suture is attached to the anterior papillary muscle. One arm of the suture is stitched through the septal muscle and both arms are atrialized underneath the septal leaflet and tied to the annuloplasty band. In 12 patients (75 ± 6 years, EuroSCORE II 10 ± 9%), severe-torrential tricuspid regurgitation was successfully reduced to mild. Results were stable in all but one patient during follow-up (1-15 months). NYHA class and general health status was improved. This subvalvular technique is safe with the potential to generate a durable repair.
瓣环扩张是三尖瓣反流的主要机制，但右心室扩张常增加限制机制，这可能会限制其耐久性。我们描述了一种瓣下技术，将腱索的起源固定到瓣环成形术上，目的是稳定瓣膜几何形状并增加耐久性。一根 Goretex 缝线连接到前乳头肌。缝线的一条臂穿过室间隔肌，两条臂在心房间穿过隔瓣下方，并系到瓣环成形带。在 12 名患者（75±6 岁，EuroSCORE II 10±9%）中，严重的三尖瓣反流成功减轻为轻度。除了一名患者外，所有患者在随访期间（1-15 个月）结果均稳定。NYHA 心功能分级和整体健康状况得到改善。这种瓣下技术是安全的，有可能产生持久的修复效果。
