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Marcelo G. Cardarelli, MD, James S. Gammie, MD, James M

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Presentation on theme: "Marcelo G. Cardarelli, MD, James S. Gammie, MD, James M"— Presentation transcript:

1 A Novel Approach to Tricuspid Valve Replacement: The Upside Down Stentless Aortic Bioprosthesis 
Marcelo G. Cardarelli, MD, James S. Gammie, MD, James M. Brown, MD, Robert S. Poston, MD, Richard N. Pierson, MD, Bartley P. Griffith, MD  The Annals of Thoracic Surgery  Volume 80, Issue 2, Pages (August 2005) DOI: /j.athoracsur Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Excess aortic tissue and the wall component of all three sinuses of valsalva being removed. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Interrupted 4-0 polypropylene sutures with pledgets placed between the tricuspid annulus and the xenograft-sewing ring. (For clarification purpose, indicates anchoring sutures for the valve commisures, although in reality those are placed after seating the valve.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Valve is in position. Anchoring sutures for the commisures are placed on the anterior, posteroinferior, and septal walls of the right ventricle. Sutures 1 and 2 are exteriorized and tied off over pledgets. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Intraoperative image revealing massive fungal mass (F) attached to the anterior and lateral leaflets of the tricuspid valve. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Postoperative echocardiogram (6-month follow-up) of patient 3, which demonstrates the laminar flow through the tricuspid annulus. The arrows indicate the septal and one of the free-wall commissural attachments of the new valve. (LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

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