Minimally invasive, beating heart tricuspid valve surgery in a redo case.

A 73-year-old female patient was admitted to our hospital with tricuspid valve (TV) regurgitation grade IV. Past medical history revealed previous mechanical mitral valve replacement and implantation of a pacemaker. Clinically she had typical signs of chronic congestive right heart failure. Massive edema of the lower legs were detected during clinical examination. Preoperative echo confirmed severe TV regurgitation and normal function of the mechanical mitral valve. Coronary artery disease was excluded by coronary angiogram. CT scan demonstrated massive dilatation of the right heart chambers. The right ventricle was in part stuck to the sternum (Figure 1). CT scan further showed “cirrhose cardiaque” due to chronic right heart congestion. She was referred for reoperation with TV repair or replacement.