Comparison of the Tricuspid Valve Function with or without Tricuspid Valve Detachment in Closure of Ventricular Septal Defect VSD Closure with Tricuspid Valve Detachment

Objective: Ventricular septal defect (VSD) is defined as a defect in the interventricular septum. It is the second most prevalent congenital heart disease following bicuspid aortic valve and makes up 5% of congenital heart diseases. Although most VSDs tend to close on their own in the first year of life, larger defects should be percutaneously or surgically closed to prevent right ventricular strain and right ventricular failure. Considering the frequency of the procedure, a safe and effective closure without tricuspid valve and atrioventricular node injury is vital. Methods: We retrospectively included 165 patients with a diagnosis of VSD who underwent surgical closure. Depending on the excised leaflet of the tricuspid valve, the patients were divided into two groups: 86 patients (Group 1) had their anterior leaflet excised, while 79 patients (Group 2) had their posterior leaflet excised. The diagnosis was based on the results of preoperative catheter angiography and echocardiography. Echocardiography was repeated on the 1st week, 1st month, and 6-12th month to evaluate postoperative residual VSD and postoperative tricuspid regurgitation. Results: The aortic cross-clamp time, cardiopulmonary bypass time, duration of intubation, length of stay in intensive care unit and hospital, postoperative residual VSD, postoperative tricuspid regurgitation, and postoperative morbidity and mortality were evaluated in patients in Groups 1 and 2. Tricuspid regurgitation or dysfunction was not detected in any group. Furthermore, no other parameters differed between two groups. Conclusion: Our study has shown that elaborate tricuspid leaflet incision for adequate visualization allows a safe and effective closure of VSD.