use of fashioned pericardial cusps for repair of tricuspid endocarditis

ABSTRACT

A fashioned pericardial cusps and chordae were used for repair of tricuspid endocarditis. The operation was done for 4 patients [1 female and 3 males], their ages ranged from 16 to 35 years. Two of them developed the endocarditis as a complication after open heart surgery. The third one was drug abuser and the lady had the endocarditis after child-birth. All had +ve blood cultures, which could be controlled medically in three. The causative organisms were mixed in three patients. Grade 4/4 tricuspid incompetence was present in two, and 3/4 in the other two. The pulmonary artery pressure ranged from 38 to 55 mmHg. At operation, mitral valve replacement was done for two patients. Pericardial cusp replaced the septal leaflet in one patient, and the anterior leaflet, in two patients. The three leaflets were excised and replaced by two pericardial cusps in one patient. Vegetations were present in two patients only. Follow up for 1-3 years revealed [1-2]/4 tricuspid incompetence in one patient and trivial incompetence in the others