Tricuspid Valve Replacement Using the Right Atrial Appendage Valve: Techniques and 1-Year Results

Area of Science:

• Cardiovascular Surgery
• Biomaterials Engineering
• Regenerative Medicine

Background:

• Tricuspid valve replacement (TVR) is complex when repair is not feasible.
• Choosing the optimal substitute for TVR remains challenging.
• Existing prosthetic valves carry risks of complications.

Purpose of the Study:

• To introduce an innovative intraoperative valve construction technique for TVR using native right atrial appendage (RAA) tissue.
• To evaluate the short-term outcomes of this novel TVR approach.

Main Methods:

• Recruited paediatric and adult patients with unrepairable severe tricuspid regurgitation (TR) requiring TVR.
• Harvested patient's RAA tissue for intraoperative reconstruction of a native bileaflet valve.
• Utilized transthoracic echocardiography for pre-operative and 6- and 12-month post-operative assessments.

Main Results:

• Successfully performed the novel TVR procedure on 6 patients (3 with infective endocarditis, 3 with congenital anomalies).
• Achieved successful valve function with no mortality or morbidity.
• Demonstrated stable valve function with no regurgitation or stenosis at 12-month follow-up.

Conclusions:

• The novel tricuspid valve operation using native RAA tissue shows promising short-term efficacy.
• Further investigation with larger patient groups and extended follow-up periods is warranted.
• This technique offers a potential alternative for challenging TVR cases.