Success of Tricuspid Valve Detachment for Ventricular Septal Defect Closure: An Assessment of Midterm Tricuspid Valve Function

Introduction: Ventricular septal defect (VSD) is the most common congenital heart anomaly. In surgical treatment, the transatrial approach is frequently utilized because of causing less right bundle block and ventricular scarring. However, some VSDs are obscured by the chordae tendineae or a pouch formation of the septal leaflet; therefore, alternative techniques are required. In such cases, tricuspid valve detachment (TVD) provides a complete visualization and ease to access to ventricular septal defects. In this study, we evaluated the results of the patients of whom we performed TVD. Patient and Method: Our study includes 50 patients who underwent TVD during the procedure with the diagnosis of perimembranous VSD. Patients were examined by transthoracic echocardiography (TTE) before and after operation and the valvular functions are evaluated. All patients were kept in follow up for 3 months after discharge. Results: The mean age of the patients was 27.56 +/- 34.81 months. At the end of the study, all patients were in New York Heart Association class I. There was no residual shunt through VSD. Except 4 patients with mild tricuspid regurgation (TR), the TTE has not revealed any TR in majority of patients. Conclusion: We suggest that, in appropriate patients, VSD closure can be performed safely with a TVD application thru an incision of the septal leaflet of the tricuspid valve without any adverse effect on function or growth at of the valve at midterm follow-up.