Simultaneous Repair of Mitral and Tricuspid Valves Through Right Atrium and Interatrial Septum

Abstract

Secondary tricuspid regurgitation is frequently responsible for serious downgrading of the clinical status of patients whose only primary rheumatic valvular lesion is of the mitral valve. In some instances the signs of tricuspid insufficiency disappear during the period of medical preparation for standard mitral commissurotomy. In others the disturbed dynamics which result from the tricuspid failure cannot be reversed and the patient must be operated upon for the mitral lesion in spite of the defect. If sufficient benefit accrues from the surgery to diminish right-heart work load, the tricuspid ring shrinks as right ventricular distention disappears. Tricuspid valvular sufficiency then results as a more or less delayed benefit of mitral valve commissurotomy or repair. The question arises as to whether repair of the tricuspid regurgitation accomplished at the same time as repair or commissurotomy of the mitral valve would be beneficial in terms of providing more rapid and certain improvement