Related Experiment Video
Updated: Jul 20, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Indications for tricuspid valve detachment in closure of ventricular septal defect in children
Lior Sasson1, Michael G Katz, Tiberiu Ezri
1Angela & Sami Shamoon Cardiothoracic Department, The Edith Wolfson Medical Center, Holon, Israel.
Insights
Preoperative criteria for tricuspid valve detachment in ventricular septal defect repair improve surgical outcomes. Patients undergoing detachment had fewer complications than those who met criteria but did not have detachment.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Echocardiography
Background:
- Tricuspid valve detachment techniques aid visualization during ventricular septal defect (VSD) repair.
- Preoperative echocardiographic criteria may guide the decision for tricuspid valve detachment in VSD repair.
- This study investigates if VSD repair with tricuspid valve detachment offers better outcomes than standard repair in selected patients.
Purpose of the Study:
- Establish preoperative echocardiographic criteria for tricuspid valve detachment during VSD repair.
- Compare surgical outcomes between patients undergoing VSD repair with and without tricuspid valve detachment based on these criteria.
Main Methods:
- Prospective study of 179 patients undergoing VSD repair (2000-2004).
- Patients classified into three groups: Group 1 (no detachment criteria, n=84), Group 2 (detachment criteria, detachment performed, n=41), and Group 3 (detachment criteria, no detachment performed, n=53).
- Data collected on surgical complications, residual VSD, atrioventricular block, and tricuspid regurgitation.
Main Results:
- Surgical complications were significantly higher in Group 3 (26%) compared to Group 2 (10%) and Group 1 (7%).
- Residual VSD and atrioventricular block were exclusively observed in Group 3.
- Tricuspid regurgitation rates were 15% (Group 3), 9.8% (Group 2), and 7.1% (Group 1).
Conclusions:
- Preoperative criteria for tricuspid valve detachment in VSD repair are feasible.
- Performing tricuspid valve detachment in indicated patients leads to fewer postoperative complications compared to those meeting criteria but not undergoing detachment.
Background:
Different techniques have been described for tricuspid valve detachment to improve visualization in ventricular septal defect repair. Our hypothesis was that preoperative echocardiographic criteria are important in deciding which patients should undergo ventricular septal defect repair by tricuspid valve detachment, and patients who undergo this procedure may have a better surgical outcome than those who fulfilled the criteria but were actually operated on with the standard surgical approach.
Methods:
Between January 2000 and December 2004 we prospectively studied 179 patients scheduled for ventricular septal defect repair and criteria for tricuspid valve detachment were established. Of these, 84 patients did not have any criteria for tricuspid valve detachment and were classified as the control group (group 1). Ninety-five patients with at least one criterion for tricuspid valve detachment were intraoperatively divided by patients who underwent tricuspid valve detachment into group 2 (n = 41), and those who did not undergo tricuspid valve detachment into group 3 (n = 53).
Results:
Surgical complications occurred more frequently in group 3 (26%) as opposed to group 2 (10%) and group 1 (7%). Residual ventricular septal defect and atrioventricular block occurred only in group 3. Tricuspid regurgitation occurred in 15% of group 3 versus 9.8% of group 2 and 7.1% of group 1.
Conclusions:
Preoperative criteria for tricuspid valve detachment can be established before repair of ventricular septal defect. Patients who had indications for tricuspid valve detachment who actually had detachment performed during repair had fewer postoperative surgical complications as opposed to patients who fulfilled the criteria but did not undergo detachment.
Related Concept Videos
01:16Heart Valves
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
01:21Tracheostomy Decannulation
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...