Tricuspid Valve Repair for a Patient with Congenital Isolated Severe Tricuspid Regurgitation

Abstract

Manabu Shiraishi, Hideki Morita, Atsushi Yamaguchi, Hideo Adachi

Severe tricuspid regurgitation commonly results from left-sided heart disease and secondary pulmonary hypertension, while isolated tricuspid regurgitation requiring surgical intervention is extremely rare. We describe a case of an 81-year-old man presenting with congenital isolated severe tricuspid regurgitation due to annular dilatation and tricuspid valve leaflet dysfunction. Echocardiography revealed enlargement of the right atrium and dilatation of the tricuspid annulus. Significant downward displacement of the tricuspid septal leaflet (>10mm) suggesting Ebstein’s abnormality was not seen. Right cardiac catheterization confirmed elevated right atrial pressure, and no left-to-right shunt was detected at the right atrium. Upon surgery, severe annular dilatation of the tricuspid valve with a deformed anterior tricuspid leaflet was visualized. Tricuspid annuloplasty with a prosthetic ring and tricuspid repair was successfully performed with subsequent resolution of the patient’s condition.