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Tricuspid Valve Surgery for Tricuspid Regurgitation in Hypoplastic Left Heart Syndrome
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（Cardiovascular Surgery, Fukuoka Children's Hospital, Fukuoka, Japan）
| Junya Sugiura |
Hideaki Kado |
Toshihide Nakano |
| Kazuhiro Hinokiyama |
Shinichiro Oda |
Tomoki Ushijima |
| Koki Eto |
Hirohumi Onitsuka |
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We reviewed our experience of tricuspid valve surgery for tricuspid regurgitation in hypoplastic left heart syndrome（HLHS）in terms of surgical timing, surgical procedures and long-term results. From May 1991 to July 2010, 105 classic HLHS patients underwent cardiac surgery, 28 of whom underwent a total of 31 tricuspid valve surgical procedures. Tricuspid valve surgery was performed in cases of moderate or more tricuspid regurgitation（TR). Type of the first tricuspid valve surgery was as follows:Annuloplasty in 15 patients, annuloplasty＋commissure closure in 7 patients, commissure closure in 2 patients, edge-to-edge repair in 2 patients, tricuspid valve replacement in 2 patients. Three patients underwent re-operation because of progression of TR. Two of them underwent tricuspid valve repair and one of them underwent tricuspid valve replacement. Follow-up was 60.1±53.0 months. Freedom from moderate or more TR after tricuspid valve surgery was 50.9% at 1 year, 42.0% at 3 years, 36.0% at 5 years. Among 17 patients who achieved total cavopulmonary connection procedure, 35.2% of patients had moderate or more TR, but central venous pressure（9.1±2.2mmHg), cardiac index（3.5±6.8 l/min/m2), arterial oxygen saturation（94.2±1.7%）showed as good hemodynamics after a Fontan procedure as non-tricuspid valve surgery cases. Appropriately timed aggressive tricuspid valve surgery yielded as good long-term results as HLHS without tricuspid valve surgery.
Jpn. J. Cardiovasc. Surg. 40:215-220（2011）
Keywords：hypoplastic left heart syndrome, tricuspid regurgitation, tricuspid valve surgery
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