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Tricuspid Valve Detachment for Transatrial Closure of Ventricular Septal Defects

Division of Pediatric Cardiac Surgery Department of Cardiovascular and Thoracic Surgery 1 Division of Pediatric Cardiology Department of Cardiology Amrita Institute of Medical Sciences and Research Center Cochin, Kerala, India
For reprint information contact: Suresh Gururaja Rao, MCh Tel: 91 484 33 9080 Fax: 91 484 34 0801 email: sureshgrao{at}aimshospital.org Department of Cardiovascular and Thoracic Surgery, Amrita Institute of Medical Sciences and Research Center, Kochi, Cochin, Kerala 682026, India.

Tricuspid leaflet detachment improves visualization and accuracy of closure of ventricular septal defects via the transatrial route. Between July 1998 and March 2001, surgical correction was performed in 296 cases of isolated ventricular septal defect, 215 cases of tetralogy of Fallot, and 16 cases of double-outlet right ventricle. Of these, 132 patients (79 with isolated ventricular septal defect, 49 with tetralogy of Fallot, and 4 with double-outlet right ventricle) underwent transatrial repair with temporary detachment of tricuspid leaflets for ventricular septal defect closure. The septal leaflet was detached in most cases, with anterior or posterior leaflets being detached when indicated. Median duration of intensive care was 3.6 days, and median hospital stay was 7 days. There was no incidence of tricuspid regurgitation attributable to leaflet detachment, as confirmed by postoperative echocardiography. Reoperation was not required for a residual defect or tricuspid regurgitation. The benefits of temporary leaflet detachment for transatrial repair of various difficult defects far outweigh the risk of postoperative tricuspid regurgitation.

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				L. Sasson, M. G. Katz, T. Ezri, A. Tamir, A. Herman, E. L. Bove, and A. Schachner Indications for tricuspid valve detachment in closure of ventricular septal defect in children. Ann. Thorac. Surg., September 1, 2006; 82(3): 958 - 963. [Abstract] [Full Text] [PDF]