The 'clover technique' as a novel approach for correction of post-traumatic tricuspid regurgitation
| Autor: | Elisabetta Lapenna, A Quarti, Ottavio Alfieri, Eustachio Agricola, Francesco Maisano, M. De Bonis |
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| Přispěvatelé: | Alfieri, Ottavio, DE BONIS, Michele, Lapenna, E, Agricola, E, Quarti, A, Maisano, F., Alfieri O., De Bonis M., Lapenna E., Agricola E., Quarti A., Maisano F. |
| Jazyk: | angličtina |
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Regurgitation (circulation) Wounds Nonpenetrating Asymptomatic law.invention Tricuspid Valve Insufficiency law Internal medicine Cardiopulmonary bypass Humans Medicine cardiovascular diseases Aged New York Heart Association Class I Heart Valve Prosthesis Implantation Cardiopulmonary Bypass Tricuspid valve business.industry Stroke Volume Tricuspid insufficiency medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Echocardiography Ventricle cardiovascular system Cardiology Female Tricuspid Valve medicine.symptom business Cardiology and Cardiovascular Medicine Tricuspid valve Clover technique Follow-Up Studies |
| Popis: | Objective: To describe a novel technique, named "clover," to correct complex post-traumatic tricuspid valve lesions. Methods: Five patients with severe post-traumatic tricuspid insufficiency underwent valve reconstruction with the clover technique, a new surgical approach that consists of stitching together the middle point of the free edges of the tricuspid leaflets, producing a clover-shaped valve. The mechanism of tricuspid regurgitation was complex in all patients, and right ventricular function was always moderately to severely depressed. An echocardiographic study was performed after cardiopulmonary bypass, at discharge, and at follow-up. Results: Cardiopulmonary bypass time was 32 +/- 6.3 minutes and crossclamp time was 23 +/- 7.4. There was no hospital mortality or morbidity. Intraoperative transesophageal and predischarge transthoracic echocardiography showed perfect results in all patients. No late deaths occurred. At the latest follow-up, extending to 14.2 months (mean 11.3; median 12.4), all patients were asymptomatic (New York Heart Association class 1) with trivial (2 patients) or no residual regurgitation (3 patients) on 2-dimensional echocardiogram. No transvalvular gradient was revealed in any patient. A significant reduction of the right ventricular end-diastolic dimensions was noted as well (from 54 +/- 7.1 mm to 40 +/- 7.5 mm, P < .001). Conclusions: In this preliminary experience, the clover technique increased the feasibility of tricuspid valve repair in case of severe traumatic tricuspid valve insufficiency, leading to very satisfactory mid-term results even in the presence of complex lesions or dilatation and deterioration of the right ventricle. |
| Databáze: | OpenAIRE |
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