Tricuspid Valvuloplasty, Repair, and Replacement

Introduction

Tricuspid valvuloplasty, tricuspid valve repair, and tricuspid valve replacement are surgical procedures performed to treat tricuspid valve disorders. The tricuspid valve is one of the four heart valves that regulate blood flow between the heart chambers.

Tricuspid Valvuloplasty

Tricuspid valvuloplasty is a minimally invasive procedure used to treat tricuspid stenosis or regurgitation. The goal of this procedure is to repair the valve without replacing it. During the procedure:

• A catheter is inserted through a vein in the leg and guided to the heart.
• A balloon on the catheter is inflated to stretch the valve opening, improving blood flow.
• In some cases, a stent may be placed to keep the valve open.

Tricuspid Valve Repair

Tricuspid valve repair is a surgical procedure that involves repairing the damaged or diseased valve. The goal of this procedure is to preserve the natural valve and avoid replacement. Techniques used in tricuspid valve repair include:

• Annuloplasty: repairing or replacing the ring-like structure that supports the valve.
• Leaflet repair: repairing or replacing the valve leaflets.
• Chordal transfer: transferring healthy chordae tendineae from one part of the heart to another.

Tricuspid Valve Replacement

Tricuspid valve replacement is a surgical procedure that involves removing the damaged or diseased valve and replacing it with an artificial valve. The new valve can be:

• Mechanical: made of metal or plastic, requiring lifelong anticoagulation therapy.
• Biological: made from animal tissue or human donor tissue, which may not require long-term anticoagulation therapy.

Risks and Complications

As with any surgical procedure, tricuspid valvuloplasty, repair, and replacement carry risks and potential complications, including:

• Bleeding or hemorrhage.
• Infection.
• Stroke or transient ischemic attack (TIA).
• Heart failure or cardiogenic shock.
• Arrhythmias or abnormal heart rhythms.

Postoperative Care and Recovery

After the procedure, patients typically require:

• Monitoring in an intensive care unit (ICU) for several days.
• Pain management and medication to prevent infection and promote healing.
• A gradual return to normal activities over several weeks or months.
• Lifelong follow-up with a cardiologist to monitor the valve and overall heart health.