Surgical treatment of traumatic tricuspid insufficiency / 中华胸心血管外科杂志

ABSTRACT

Objective To summarize the timing, procedure and early and late outcomes of Surgical treatment of traumatic tricuspid insufficiency. Methods From May 1984 through September 2004, eight patients with traumatic tricuspid insufficiency were treated surgically. All were male, and the ages ranged from 7 to 67 years (median 38 years). Seven patients were blunt chest trauma (including traffic accidents in three). The median duration between trauma and operation was 19 months (range 1 month to 20 years). At operation, the heart functions of patients were in class II to IV (NYHA). Diagnoses were conformed by echocardiogram. The anterior leaflet was prolapsed because of the rupture of chord or anterior papillary muscle in all the patients, combined with chordal rupture of septal leaflet in one. In all the patients, right ventricular was enlarged in various degrees, as well as tricuspid annulus. In three patients, the tricuspid valve was repaired. Five cases received valve replacement, after repair failed. Results All the patients were recovered well without complication after operation. Only one of the three patients after tricuspid valve repair was detected mild tricuspid regurgitation by echocardiogram. The mean postoperative hospital stay was (16.6?6.5) days (7 to 24 days). The median follow-up period was 39 months (range 7 to 129 months). The heart functions were improved to class I (NYHA) in all patients. Conclusion The outcome of surgical treatment of traumatic tricuspid valve insufficiency is good. Surgical intervention should be done as early as possible once diagnosis was made to increase the feasibility of tricuspid valve repair. Tricuspid valve repair is the procedure of choice, while tricuspid valve replacement is also acceptable according to the long-term result of this report.