Adjustable tricuspid valve annuloplasty assisted by intraoperative transesophageal color Doppler echocardiography

• Published in: The American journal of cardiology Vol. 71; no. 11; pp. 926 - 931
• Main Authors: De Simone, Raffaele, Lange, Rüdiger, Tanzeem, Ahmed, Gams, Emmeram, Hagl, Siegfried
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15-04-1993; Elsevier; Elsevier Limited
• Subjects: Adult; Aortic Valve - surgery; Biological and medical sciences; Echocardiography; Echocardiography, Doppler - methods; Esophagus; Female; Heart; Heart Valve Prosthesis; Humans; Male; Medical research; Medical sciences; Middle Aged; Mitral Valve - surgery; Monitoring, Intraoperative - methods; Regional Blood Flow; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Tricuspid Valve - diagnostic imaging; Tricuspid Valve - physiopathology; Tricuspid Valve - surgery; Tricuspid Valve Insufficiency - diagnostic imaging; Tricuspid Valve Insufficiency - physiopathology; Tricuspid Valve Insufficiency - surgery; Ultrasonic imaging; Doppler ultrasound study; Sonography; Human; Echocardiography; Color; Cardiovascular disease; Suturation; Annuloplasty; Guidance; Treatment; Surgery; Technique; Tricuspid valve
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(93)90908-U

Intraoperative transesophageal echocardiography (TEE) can play a major rote in active guidance of cardiac surgery. This study describes a new application of TEE for assisting tricuspid suture annuloplasty. Twenty-five patients (aged 52 ± 11 years) who underwent mitral valve replacement and tricuspid valve annuloplasty were studied intraoperatively by TEE. After cardiopulmonary bypass, the suture annuloplasty was adjusted on the beating heart until palpable regurgitation was eliminated. Further adjustment of the suture was performed under echocardiographic guidance until color Doppler flow imaging showed the most adequate correction of tricuspid regurgitation (TR). A significant decrease in the semiquantitative grade of TR, of regurgitant jet area and of the ratio jet area/right atrial area was obtained when the suture was adjusted under echocardiographic guidance. The peak inflow velocity and the gradient across the tricuspid valve did not show significant changes throughout the procedures. The results showed that the tricuspid suture annuloplasty guided by TEE enables a substantial reduction in residual TR without creating valve stenosis.