4. Tricuspid Valve Disease

Q: What kinds of disease are there in Tricuspid Valve? How are they fixed?

Tricuspid valve disease (mostly regurgitation) is usually associated with mitral valve disease. For the disease, valve repair surgery especially annuloplasty surgery which makes the annulus (i.e., base of the valve leaflets) smaller is effective.  For tricuspid annuloplasty, there are a few methods including: DeVega method that makes the tricuspid annulus smaller by sutures around the annulus, and Ring annuloplasty that employs some kind of ring (rigid or flexible, 2D or 3D shape, etc.). Generally, DeVega is easy and quick method while ring annuloplasty takes a little longer time, but more effective and longer lasting.

We use the ring for severe tricuspid regurgitation and DeVega method for mild-moderate regurgitation. Some patients who had a few surgeries in the long time period and developes just tricuspid regurgitation; we just open the right chest and open the right atrium without taping the venae cavae using some techniques, and make the surgery less invasive.

Q: Can Pacemaker cables cause tricuspid regurgitation?

Cables of permanent pacemaker are known to cause tricuspid regurgitation. When there are 2 or more cables across the valve, chances of tricuspid regurgitation become higher and chances for valve repair less. We fix the problem by not only valve repair but also relocating the pacer cables and employing artificial chordae when necessary. To date, long-term results of tricuspid replacement remains unknown, and therefore we believe such sophisticated repair method beneficial for the patients.