Abstract
Congratulations to Roshanali and colleagues1Roshanali F. Saidi B. Mandegar M.H. Yousefnia M.A. Alladdini F. Echocardiographic approach to the decision-making process for tricuspid valve repair.J Thorac Cardiovasc Surg. 2010; 139: 1483-1487Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar for their valuable study, “Echocardiographic Approach to the Decision-Making Process for Tricuspid Valve Repair,” which appeared in the June 2010 issue. Functional tricuspid regurgitation develops secondary to the annular dilation as a result of enlargement of the right ventricular cavity, which in turn is related to the increase in pulmonary arterial pressure secondary to left ventricular pathology. This physiopathology does not coincide with the view provided by Roshanali and colleagues' original Figure 1,1Roshanali F. Saidi B. Mandegar M.H. Yousefnia M.A. Alladdini F. Echocardiographic approach to the decision-making process for tricuspid valve repair.J Thorac Cardiovasc Surg. 2010; 139: 1483-1487Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar because elongation of the leaflets and chordae is seen in regurgitation. The absence of coaptation depth among the data given in their original Table 1 supports our claim.1Roshanali F. Saidi B. Mandegar M.H. Yousefnia M.A. Alladdini F. Echocardiographic approach to the decision-making process for tricuspid valve repair.J Thorac Cardiovasc Surg. 2010; 139: 1483-1487Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar The criterion for pericardial patch use is unclear, although preoperative tricuspid annular diameter is given in their original Table 1.1Roshanali F. Saidi B. Mandegar M.H. Yousefnia M.A. Alladdini F. Echocardiographic approach to the decision-making process for tricuspid valve repair.J Thorac Cardiovasc Surg. 2010; 139: 1483-1487Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar The ring size and the method of reduction of annular diameter are unclear as well. We think that—at least in this study—the correlation between the degree of postoperative tricuspid regurgitation and pulmonary arterial pressure should be investigated. The number of patients in this study is adequate for such statistical analysis. Reevaluation of the data therefore could yield important results. Echocardiographic approach to the decision-making process for tricuspid valve repairThe Journal of Thoracic and Cardiovascular SurgeryVol. 139Issue 6PreviewCommonly used procedures to repair functional tricuspid regurgitation have a high failure rate. The present study was designed to lower this failure rate by reducing leaflet tethering via pericardial patch augmentation when the preoperative probability of recurrence was high. Full-Text PDF
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