Preservation of systemic tricuspid valve function by pulmonary conduit banding in a patient with corrected transposition of the great arteries.

Interactive Cardiovascular and Thoracic Surgery
Ersin ErekAlper Güzeltas

Abstract

Systemic tricuspid valve regurgitation increases mortality and morbidity in patients with a corrected transposition of the great arteries. A 17-year old male with a physiologically corrected transposition after the closure of a ventricular septal defect and conduit placement between a morphological left ventricle and pulmonary artery presented with exertional dyspnoea. The transthoracic echocardiography showed a severe conduit stenosis, and cardiac catheterization revealed a pressure gradient of 114 mmHg. The patient underwent conduit re-replacement using a pulmonary heterograft. Intraoperative transoesophageal echocardiography revealed an acute severe tricuspid regurgitation after a conduit re-replacement. Pulmonary conduit banding was performed under transoesophageal echocardiography guidance, during which the left ventricular to right ventricular pressure ratio increased from 0.33 to 0.60 and the degree of tricuspid regurgitation decreased mildly. The patient was discharged uneventfully at postoperative day 16. Conduit banding might be a useful technique to preserve the systemic tricuspid valve function during conduit re-replacement in patients with a corrected transposition.

References

Sep 29, 2004·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Masahiro KohSoichiro Kitamura
Apr 7, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Mohamedou LyAlain Serraf

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