A Case of Tricuspid Valve Repair with an Artificial Chordae for Juvenile Tricuspid Regurgitation due to Chordal Rupture and Cleft of the Anterior Leaflet

Shigeki Koizumi＊	Tadashi Takasaki＊	Atsushi Nagasawa＊
Tadaaki Koyama＊

（Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital＊, Kobe, Japan）

A 34-year-old man was referred to our hospital for primary tricuspid regurgitation. An echocardiogram showed severe tricuspid regurgitation caused by the prolapse of the anterior leaflet due to chordal rupture and enlargement of the tricuspid annulus. A large cleft on the anterior leaflet and a divided leaflet near the septal leaflet with a ruptured chorda were observed during surgery. We attached an artificial chorda from the anterior papillary muscle of the right ventricle to the prolapsed leaflet. We then repaired the large cleft with interrupted 6-0 polypropylene sutures and performed tricuspid annuloplasty. The prolapse of the anterior leaflet disappeared, and an intraoperative transesophageal echocardiogram revealed improvement of tricuspid regurgitation. The technique of mitral valve repair can be used even for a complex pathology of congenital cleft, chordal rupture, and annular enlargement of the tricuspid valve.

 

Jpn. J. Cardiovasc. Surg. 48:324-326（2019）

Keywords：tricuspid regurgitation;cleft;artificial chordae;tricuspid valve repair