What is tricuspid valve replacement surgery?
Tricuspid valve repair and tricuspid valve replacement are treatment options for patients who suffer from tricuspid valve disease. The tricuspid valve is the heart valve that separates the right atrium from the right ventricle. The main function of the tricuspid valve is to allow the blood to flow from the right atrium to the right ventricle. If it is not functioning correctly, blood could flow backward into the heart and affect the heart’s ability to pump oxygen-rich blood to the body.
The goal of tricuspid valve repair or tricuspid valve replacement is to restore normal blood flow from the right atrium to the right ventricle, alleviate symptoms and increase life span.
Who is a candidate for tricuspid valve repair or tricuspid valve replacement surgery?
If you have moderate to severe tricuspid regurgitation or tricuspid valve stenosis, you may be a candidate for tricuspid valve repair or tricuspid valve replacement.
Tricuspid valve regurgitation occurs when the blood flows backward into the atrium instead of into the ventricle after the heart pumps because the tricuspid valve did not close properly.
Tricuspid valve stenosis occurs when the tricuspid valve becomes narrowed or blocked — making it harder for the blood to flow through into the right ventricle. Many patients have tricuspid valve stenosis and tricuspid valve regurgitation simultaneously.
Tricuspid stenosis can be caused by:
- Congenital heart disease
- Abnormal hardening of the tricuspid leaflets
- Rheumatic fever
- Carcinoid heart disease
Tricuspid atresia occurs in fetal development when the tricuspid valve does not fully form. Babies born without a well-defined tricuspid valve may need immediate surgery to increase blood flow to the lungs.
Should I get a tricuspid valve repair or tricuspid valve replacement?
Your cardiovascular team will evaluate your case to determine if you should have tricuspid valve repair or tricuspid valve replacement surgery. The team will take into consideration your overall health, the severity of your condition and the need for other repairs at the same time as the tricuspid repair.
Although heart valve repair is typically performed due to the lower risks associated with the procedure, some valves can’t be repaired. Heart valve repair surgery is typically more challenging to perform than tricuspid valve replacement surgery.
What to expect during tricuspid valve repair?
Most tricuspid valve repair surgeries are performed via open-heart surgery. You surgeon will cut a large incision in your chest bone and place you on a heart-lung machine to keep your body functioning while the valve is being repaired. Once the procedure is completed, your doctors will wire the chest back together.
Tricuspid valve repair surgery may be needed to:
- Patch holes/tears in the leaflets
- Add support to the base of the tricuspid valve
- Separate fused leaflets
- Remove tissue to enable the valve to close tightly
- Reinforce the annulus with an artificial ring
Some patients may be candidates for minimally invasive tricuspid valve repair. Balloon valvuloplasty is a less invasive procedure used to repair tricuspid valves that don’t fully open. During this procedure, your doctor will use a catheter inserted into your heart — once the catheter is in position, a balloon at the end of the catheter will inflate to widen the tricuspid valve.
Typically, minimally invasive tricuspid valve repair is easier on the body and recovery time is quicker.
What to expect during tricuspid valve replacement surgery?
Tricuspid valve replacement surgery involves replacing the failing tricuspid valve with a mechanical or biological tissue valve. A biological tissue valve is made from cow or pig valves, while a mechanical valve is a man-made valve. Patients who have a biological valve may need a replacement within 15 to 20 years. Patients with mechanical valves need blood thinning medication for life to prevent blood clots. Your doctor will evaluate the options with you to determine the most appropriate treatment option for your case.
Tricuspid valve replacement surgery can be performed via open-heart surgery or minimally invasive techniques. Minimally invasive techniques involve small incisions and faster recovery time. There are some robotic procedures that may be used to replace the tricuspid valve.
Risks of tricuspid valve repair or tricuspid valve replacement surgery
Complications associated with tricuspid valve repair and tricuspid valve replacement can be minimized by having tricuspid valve repair or tricuspid valve replacement surgery at an experienced cardiac-focused facility with an experienced surgeon.
Complications could include: