Tricuspid Valve Reconstruction in a Patient with Ventricular Septal Defect and Subacute Endocarditis

Objective: Tricuspid valve reconstruction was advocated as the operative method for the treatment of tricuspid valve endocarditis recently. Many people accept that valve replacement therapy should be performed if more than two valve leaflets are involved. The aim of the study to discuss if reconstructive surgery could be done to treat two valve leaflets involved in tricuspid valve endocarditis. Methods: A 17-year-old boy with ventricular septal defect (VSD) and tricuspid valve subacute endocarditis was surgical treated through extracorporeal circulation. two-thirds of the defective septal cusp, and half of the defective anterior cusp were excised during operation. The tricuspid valve was reconstructed with autologous pericardial strip, cusp commissuroplasty and 4-0 prolene sutures made as chordae tendineaes. VSD was repaired using a pericardial patch. Results: The patient was discharged post-operation with excellent restoration of the tricuspid valve activity. Cardiac ultrasound revealed normal tricuspid valve activity and low degree of regurgitation two years follow-up. Conclusions: It seems that tricuspid valve reconstruction could be performed for two defective leaflets or half of the tricuspid valve.