Right-sided double valve replacement in an adult patient who underwent surgery for pulmonary stenosis in childhood: a case report

J Cardiothorac Surg. 2020 Jul 14;15(1):170. doi: 10.1186/s13019-020-01207-x.

Abstract

Background: Pulmonary regurgitation and the subsequent functional tricuspid regurgitation are frequently observed in adult patients who previously underwent pulmonary valvular operations. Pulmonary valve replacement, in combination with tricuspid annuloplasty, is frequently performed in adult patients. However, postoperative worsening or recurrence of tricuspid regurgitation is a major concern after pulmonary valve replacement with tricuspid annuloplasty.

Case presentation: Herein, we describe the case of a 56-year-old woman with severe pulmonary regurgitation and functional tricuspid regurgitation after congenital pulmonary stenosis surgery in childhood. Functional tricuspid regurgitation was due to tricuspid annular dilatation, marked right ventricle enlargement, and significant tethering. We performed a bioprosthetic double valve replacement, and the postoperative course was uneventful. The patient is doing well one year after the surgery without prosthetic valve dysfunction.

Conclusions: When functional tricuspid regurgitation is severe and is associated with right ventricular dilatation and subsequent tethering, tricuspid valve replacement rather than annuloplasty should be considered.

Keywords: Bioprosthesis; Case report; Functional tricuspid regurgitation; Pulmonary valve replacement; Tricuspid valve replacement.

Publication types

  • Case Reports

MeSH terms

  • Echocardiography
  • Female
  • Heart Valve Prosthesis Implantation
  • Humans
  • Middle Aged
  • Pulmonary Valve / surgery
  • Pulmonary Valve Insufficiency / diagnostic imaging
  • Pulmonary Valve Insufficiency / surgery*
  • Pulmonary Valve Stenosis / surgery*
  • Survivors
  • Tricuspid Valve / surgery
  • Tricuspid Valve Insufficiency / diagnostic imaging
  • Tricuspid Valve Insufficiency / surgery*