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Tricuspid valvuloplasty for isolated tricuspid regurgitation in children

Published online by Cambridge University Press:  25 June 2020

Guanxi Wang Open the ORCID record for Guanxi Wang [Opens in a new window] ,
Kai Ma ,
Kunjing Pang ,
Sen Zhang ,
Lei Qi ,
Yang Yang ,
Zicong Feng ,
Fengqun Mao ,
Jianhui Yuan  and
Hao Zhang
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Guanxi Wang
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Kai Ma
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Kunjing Pang
Affiliation:
Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Sen Zhang
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Lei Qi
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Yang Yang
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Zicong Feng
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Fengqun Mao
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Jianhui Yuan
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
Hao Zhang
Affiliation:
Heart Center and Shanghai Institute of Pediatric Congenital Heart Diseases, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai200127, China
Shoujun Li*
Affiliation:
Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Street, Xicheng District, Beijing100037, China
*
Address for correspondence: Shoujun Li, MD, Pediatric Cardiac Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing100037, PR China. Tel: +86(10)88398855; Fax: +86(10)88398855. E-mail: [email protected]
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Abstract

Background:

Isolated congenital tricuspid regurgitation other than Ebstein’s anomaly was rare especially for children. The objective of this study was to investigate the clinical characteristics and to assess the results of tricuspid valvuloplasty for children with isolated tricuspid regurgitation.

Methods:

From January 2010 to June 2019, 10 consecutive patients with isolated tricuspid regurgitation who were unresponsive to drug therapy underwent tricuspid valvuloplasty in our hospital. Patients’ clinical data were analysed retrospectively.

Results:

Mean age at operation was 48.5 ± 31.0 (range: 9–106) months and mean weight at operation was 16.1 ± 6.9 (range: 8.6–33.0) kg. All patients presented severe isolated tricuspid regurgitation. According to pathological lesions, the main causes accounted for chordae tendinea rupture (3/10), leaflet cleft (2/10), mal-connected chordal tendinea to leaflets (2/10), elongated chordae (1/10) and chordae absent (1/10), and severe anterior leaflet dysplasia (1/10). Individualised tricuspid valvuloplasty was adapted to all of them successfully. Post-operative echocardiography showed no tricuspid regurgitation in two patients and mild regurgitation in eight patients. The cardiothoracic ratios on their chest roentgenograms decreased from 0.59 ± 0.05 to 0.54 ± 0.05. At the latest follow-up (50.4 ± 47.2 months), echocardiography showed that mild to moderate tricuspid regurgitation in seven patients, moderate tricuspid regurgitation in three patients, and no patient with severe tricuspid regurgitation. All patients were in NYHA functional class I.

Conclusions:

For patients with isolated tricuspid regurgitation who were not well responsive to drug therapy, individualised tricuspid valve repair can achieve an excellent result.

Keywords

Tricuspid regurgitationtricuspid valvuloplastyleaflet cleftCHDs
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 8 , August 2020 , pp. 1076 - 1080
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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