Tricuspid Valve Reconstruction in a Patient with Ventricular Septal Defect and Subacute Endocarditis

摘要

Objective Tricuspid valve reconstruction was advocated as the operative method for the treatment of tricus-pid valve endocarditis recently. Many people accept that valve replacement therapy should be performed if more than two valve leaflets are involved. The aim of the study to discuss if reconstructive surgery could be done to treat two valve leaflets involved in tricuspid valve endocarditis. Methods A 17-year-old boy with ventricular septal defect (VSD) and tricuspid valve subacute endocarditis was surgical treated through extra-corporeal circulation. two-thirds of the defective septal cusp, and half of the defective anterior cusp were ex-cised during operation. The tricuspid valve was reconstructed with autologous pericardial strip, cusp com-missuroplasty and 4-0 prolene sutures made as chordae tendineaes. VSD was repaired using a pericardial patch. Results The patient was discharged post-operation with excellent restoration of the tricuspid valve ac-tivity. Cardiac ultrasound revealed normal tricuspid valve activity and low degree of regurgitation two years follow-up. Conclusions It seems that tricuspid valve reconstruction could be performed for two defective leaflets or half of the tricuspid valve.