Preservation of systemic tricuspid valve function by pulmonary conduit banding in a patient with corrected transposition of the great arteries

Interact Cardiovasc Thorac Surg. 2012 Aug;15(2):332-4. doi: 10.1093/icvts/ivs176. Epub 2012 May 9.

Abstract

Systemic tricuspid valve regurgitation increases mortality and morbidity in patients with a corrected transposition of the great arteries. A 17-year old male with a physiologically corrected transposition after the closure of a ventricular septal defect and conduit placement between a morphological left ventricle and pulmonary artery presented with exertional dyspnoea. The transthoracic echocardiography showed a severe conduit stenosis, and cardiac catheterization revealed a pressure gradient of 114 mmHg. The patient underwent conduit re-replacement using a pulmonary heterograft. Intraoperative transoesophageal echocardiography revealed an acute severe tricuspid regurgitation after a conduit re-replacement. Pulmonary conduit banding was performed under transoesophageal echocardiography guidance, during which the left ventricular to right ventricular pressure ratio increased from 0.33 to 0.60 and the degree of tricuspid regurgitation decreased mildly. The patient was discharged uneventfully at postoperative day 16. Conduit banding might be a useful technique to preserve the systemic tricuspid valve function during conduit re-replacement in patients with a corrected transposition.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Multiple*
  • Adolescent
  • Blalock-Taussig Procedure / adverse effects*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Congenitally Corrected Transposition of the Great Arteries
  • Device Removal
  • Echocardiography, Doppler, Color
  • Echocardiography, Transesophageal
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Graft Occlusion, Vascular / surgery*
  • Hemodynamics
  • Humans
  • Ligation
  • Male
  • Pulmonary Artery / physiopathology
  • Pulmonary Artery / surgery*
  • Reoperation
  • Transposition of Great Vessels / complications
  • Transposition of Great Vessels / diagnosis
  • Transposition of Great Vessels / physiopathology
  • Transposition of Great Vessels / surgery*
  • Treatment Outcome
  • Tricuspid Valve / physiopathology*
  • Tricuspid Valve Insufficiency / diagnosis
  • Tricuspid Valve Insufficiency / etiology
  • Tricuspid Valve Insufficiency / physiopathology
  • Tricuspid Valve Insufficiency / surgery*
  • Ventricular Function, Left
  • Ventricular Function, Right
  • Ventricular Pressure