Case Report: Tricuspid Annuloplasty for Right-Sided Congestive Heart Failure Secondary to Pulmonary Hypertension in a Dog.

An 11-year-old, 12.3-kg, female Miniature Dachshund was presented to our institution with ascites of unknown etiology. The dog had been administered moxidectin for 3 years to treat a heartworm infection. Thoracic radiographs showed enlargement of the right heart. Echocardiography revealed right atrial and ventricular dilatation as well as flattening of the interventricular septum. Heartworm was identified in the main pulmonary artery, which was dilated. Tricuspid regurgitation (TR) was observed using color Doppler ultrasonography, and 2.5 L of ascites were removed. The dog was diagnosed with pulmonary hypertension, severe TR, and right-sided congestive heart failure. Except at the initial site, heartworm was not detected using echocardiography, and the antigen test was negative. However, pharmacological treatment did not improve the right-sided congestive heart failure. Instead, De Vega tricuspid annuloplasty (TAP) was performed on the beating heart under cardiopulmonary bypass with the owner's consent. Sutures terminated between the two commissures in the middle of the annulus and were secured using another pledget. Annular reduction was performed by tying down the plication suture while the cylindrical sizer was inserted into the tricuspid valve orifice. The size of the cylindrical sizer was 16 mm, which was set based on the height and width of the septal leaflet. A 6-month follow-up showed a reduction of TR and right-sided volume overload with no evidence of ascites retention/recurrence or any other complication. Our findings indicate that TAP may be a valid treatment option for dogs with right-sided congestive heart failure caused by secondary TR.

Early Outcomes of Modified De Vega Annuloplasty for Functional Tricuspid Regurgitation at a Brazilian Hospital

Abstract Background: Right valve diseases are not benign, the tricuspid regurgitation has a significant impact on morbidity and mortality of patients. Objectives: This study aimed to report the short-term results of tricuspid annuloplasty using the De Vega technique modified by Manuel Antunes. Methods: A descriptive-analytical study was performed to evaluate the results of the tricuspid valvuloplasty performed at the Instituto de Medicina Integral Professor Fernando Figueira between 2012 and 2017. Data were collected by reviewing charts and databases of the Department of Cardiology and Cardiovascular Surgery of the institution. Those with rheumatic diseases or infective endocarditis with tricuspid valve involvement, or reoperation of the tricuspid valve were excluded. Student's t-test and McNemar's were used for statistical analysis. A p-value < 0.05 was considered statistically significant. Results: A total of 87 patients were studied, most of them were women (56.3%). The most associated heart valve diseases were mitral regurgitation (27.6%) and aortic regurgitation (20.7%). There was a significant decrease in the degree of tricuspid regurgitation in the postoperative period, with 83.3% of patients with none or mild regurgitation and only 1.1% with severe regurgitation (p = 0.0077). Conclusions: In the current study, tricuspid valve annuloplasty using the modified De Vega technique was shown to be effective in the short term. Further studies are needed to evaluate the long-term results.

Excision of a left atrial myxoma with mitral and tricuspid valve repair.

A left atrial myxoma is the most common benign tumor of the heart, but it is still uncommon, with a reported prevalence of 0.03% in the general population. In developing countries, patients may present late with a stroke or with pulmonary artery hypertension and ventricular dysfunction. We may need to address the mitral and tricuspid valves in such cases. This video tutorial illustrates the technical aspects of myxoma excision along with modified De Vega tricuspid annuloplasty. The mitral valve was structurally normal and free from tumor; therefore, it was not touched in the first place but had to be repaired because there was severe regurgitation after the tumor was excised. The presence of left ventricular dysfunction can indicate a dilated mitral annulus and the need to repair the mitral valve.

[Surgical repair of secondary tricuspid regurgitation]. / Khirurgicheskaia korrektsiia vtorichnoi nedostatochnosti trikuspidal'nogo klapana.

Optimal surgical strategy for secondary tricuspid regurgitation is still under discussion. First of all, this is due to rare organic disease of tricuspid valve and tricuspid regurgitation is almost always classified as secondary insufficiency. Fibrous annulus enlargement of tricuspid valve is the most common cause of tricuspid regurgitation. Annular dilatation may by the result of left ventricular failure due to myocardial or valvular diseases, right ventricular enlargement, pressure or volume overload. No surgical correction of tricuspid insufficiency during cardiac surgery for other leading disease aggravates short- and long-term results. Considering the wide interest and disputes around optimal surgical strategy for tricuspid regurgitation, this review is devoted to modern methods of surgical treatment of secondary tricuspid insufficiency.

Effectiveness of Surgical Tretment of Modified De Vega Technique and Traditional De vega Technique in Functional Tricuspid Regurgitation / 医学研究杂志

0.05).The proportion of TR degree improved in patients of two groups in a short-term.However,the difference of TR in long-term between two groups was statistically significant(P