The concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double-orifice tricuspid valveCentral MessagePerspective
Objectives: Isolated tricuspid valve dysplasia is a rare disease characterized by a wide spectrum of possible anomalies. We describe the use of the Cone concept to treat a patient with a double-orifice tricuspid valve with massive regurgitation and severe deficit of coaptation. Methods: Three adult...
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Elsevier
2023-08-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250723001396 |
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| author | Andrea Giulio Quarti, MD Francesco Dimitri Petridis, PhD Valeria Francesca Mangerini, MD Lucio Careddu, PhD Emanuela Angeli, PhD Gaetano Domenico Gargiulo, PhD |
| author_facet | Andrea Giulio Quarti, MD Francesco Dimitri Petridis, PhD Valeria Francesca Mangerini, MD Lucio Careddu, PhD Emanuela Angeli, PhD Gaetano Domenico Gargiulo, PhD |
| author_sort | Andrea Giulio Quarti, MD |
| collection | DOAJ |
| description | Objectives: Isolated tricuspid valve dysplasia is a rare disease characterized by a wide spectrum of possible anomalies. We describe the use of the Cone concept to treat a patient with a double-orifice tricuspid valve with massive regurgitation and severe deficit of coaptation. Methods: Three adult patients with congenital non-Ebstein tricuspid valve anomaly characterized by severe coaptation deficiency underwent tricuspid valve repair applying the Cone technique. In particular, we describe the case of a symptomatic 21-year-old woman with a double-orifice tricuspid valve, with massive regurgitation and severe right ventricular dilatation. The tricuspid valve was transformed from a double-orifice valve into a single-orifice valve. The most superior orifice was opened, and the tissue surrounding the orifice was used to extend the leaflet of the inferior orifice. A Cone was created, and a ring annuloplasty was used to stabilize the result. Results: The patient was discharged home after 7 days with trivial residual tricuspid regurgitation and no significant antegrade gradient. The final coaptation height was 2.8 cm. The cardiothoracic ratio decreased from 0.77 to 0.59 after 2 months, and symptoms promptly improved. Conclusions: Over the past 2 years, we have applied the Cone creation concept to patients with a severely dysplastic tricuspid valve with excellent early results. One patient had a double-orifice tricuspid valve, and a Cone repair concept was adopted anyway. One orifice was sacrificed, and surrounding tissue was used to augment the leaflets of the other orifice. A Cone was created to improve central coaptation with a good initial result. |
| format | Article |
| id | doaj-art-df1a8f1cbf794aa4aaf1ad01af7e813c |
| institution | DOAJ |
| issn | 2666-2507 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-df1a8f1cbf794aa4aaf1ad01af7e813c2025-08-20T03:04:47ZengElsevierJTCVS Techniques2666-25072023-08-0120717810.1016/j.xjtc.2023.04.013The concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double-orifice tricuspid valveCentral MessagePerspectiveAndrea Giulio Quarti, MD0Francesco Dimitri Petridis, PhD1Valeria Francesca Mangerini, MD2Lucio Careddu, PhD3Emanuela Angeli, PhD4Gaetano Domenico Gargiulo, PhD5Address for reprints: Andrea Giulio Quarti, MD, Pediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40128 Bologna, Italy.; Pediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyPediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyPediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyPediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyPediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyPediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyObjectives: Isolated tricuspid valve dysplasia is a rare disease characterized by a wide spectrum of possible anomalies. We describe the use of the Cone concept to treat a patient with a double-orifice tricuspid valve with massive regurgitation and severe deficit of coaptation. Methods: Three adult patients with congenital non-Ebstein tricuspid valve anomaly characterized by severe coaptation deficiency underwent tricuspid valve repair applying the Cone technique. In particular, we describe the case of a symptomatic 21-year-old woman with a double-orifice tricuspid valve, with massive regurgitation and severe right ventricular dilatation. The tricuspid valve was transformed from a double-orifice valve into a single-orifice valve. The most superior orifice was opened, and the tissue surrounding the orifice was used to extend the leaflet of the inferior orifice. A Cone was created, and a ring annuloplasty was used to stabilize the result. Results: The patient was discharged home after 7 days with trivial residual tricuspid regurgitation and no significant antegrade gradient. The final coaptation height was 2.8 cm. The cardiothoracic ratio decreased from 0.77 to 0.59 after 2 months, and symptoms promptly improved. Conclusions: Over the past 2 years, we have applied the Cone creation concept to patients with a severely dysplastic tricuspid valve with excellent early results. One patient had a double-orifice tricuspid valve, and a Cone repair concept was adopted anyway. One orifice was sacrificed, and surrounding tissue was used to augment the leaflets of the other orifice. A Cone was created to improve central coaptation with a good initial result.http://www.sciencedirect.com/science/article/pii/S2666250723001396cone repaircongenital heart diseasetricuspid dysplasiatricuspid regurgitation |
| spellingShingle | Andrea Giulio Quarti, MD Francesco Dimitri Petridis, PhD Valeria Francesca Mangerini, MD Lucio Careddu, PhD Emanuela Angeli, PhD Gaetano Domenico Gargiulo, PhD The concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double-orifice tricuspid valveCentral MessagePerspective JTCVS Techniques cone repair congenital heart disease tricuspid dysplasia tricuspid regurgitation |
| title | The concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double-orifice tricuspid valveCentral MessagePerspective |
| title_full | The concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double-orifice tricuspid valveCentral MessagePerspective |
| title_fullStr | The concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double-orifice tricuspid valveCentral MessagePerspective |
| title_full_unstemmed | The concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double-orifice tricuspid valveCentral MessagePerspective |
| title_short | The concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double-orifice tricuspid valveCentral MessagePerspective |
| title_sort | concept of cone creation to treat isolated tricuspid valve dysplasia and the case of a double orifice tricuspid valvecentral messageperspective |
| topic | cone repair congenital heart disease tricuspid dysplasia tricuspid regurgitation |
| url | http://www.sciencedirect.com/science/article/pii/S2666250723001396 |
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