Surgical treatment of tricuspid regurgitation after left cardiac valve replacement

Objective To summarize our experiences in surgical treatment of tricuspid regurgitation after left valve replacement. Methods Clinical data about 20 patients who developed tricuspid insufficiency after they underwent left valve replacement in our hospital from January 2007 to November 2010 were retrospectively analyzed.Of the 20 patients,8 underwent mitral valve replacement and 12 aortic and mitral double-valve replacement.The surgery was completed on beating heart under hypothermia by implanting biological tricuspid valve. Results Of the 20 patients after operation,1 died of multiple organ failure caused by low cardial output syndrome（LCOS）with a mortality of 5%,6 presented with LCOS,2 had pleural effusion,2 had renal inadequacy which was recovered after peritoneal dialysis,1 had pericardial effusion,1 presented with frequent ventricular tachycardia and ventricular Fibrillation which were recovered after defibrillation and anti-arrhythmia treatment.All the patients were recovered,except for 1 patient who died.Echocardiography revealed that the size of their right atrium and ventricle was much smaller after operation than before operation. Conclusion The effect of surgical treatment on tricuspid regurgitation after left valve replacement is satisfactory.Mild hypothermia for beating heart can effectively protect myocardium.Biological valve is a better choice.Rational indications for surgery and perioperative treatment are the key to successful surgery.