Why the study?
Does full orifice patching without annuloplasty improve outcomes in patients with severe functional tricuspid regurgitation and increased chordal tethering?
Does full orifice patching without annuloplasty improve outcomes in patients with severe functional tricuspid regurgitation and increased chordal tethering?
Full orifice patching without annuloplasty is a novel surgical technique that shows encouraging early and midterm results for severe functional tricuspid regurgitation with increased chordal tethering.
Should not yet change practice; leaves open the role of full orifice patching in severe functional TR with tethering.
Surgical treatment of severe functional tricuspid regurgitation associated with dilated right ventricle and increased chordal tethering (>8 mm) is challenging. We designed a technique where the anterior and posterior leaflets are detached from 50% of the annulus and a patch as large as the tricuspid orifice is sewn to augment the leaflets' tissue to force the coaptation with the septal leaflet. Annuloplasty is not performed, as it can only increase the chordal tethering, reducing the benefit of tissue augmentation. Early and midterm results in a subgroup of patients with unfavorable anatomical aspects are encouraging.
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Filippo et al. (2018) studied this question.
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