Prosthetic valve surgery in tricuspid area.

Up to September 20, 1975, 1,020 cases of valvular heart diseases were surgically treated at the Sapporo Medical University Hospital. In these series, there were 33 cases done for the tricuspid valve which included 27 valve replacements (81.8%) and 6 annuloplasties (18.2%). We have demonstrated that TVR may improve hemodynamic condition for any type of TI, however, postoperative A-V block and sinus bradycardias seemed to be serious complications with relatively high incidence. On the other hand, long term hemodynamic results of TAP was demonstrated to be comparable to that with TVR. Therefore, much more reliable technique of tricuspid annuloplasty may bring much better long term results. We have shown our annuloplasty "Circumferential Annular Constriction" in which a paired purse-string sutures along the tricuspid annulus may produce almost the same constricting effect as the use of a ring material.