Minimally Invasive Mitral And Tricuspid Repair In Situs Inversus Totalis
Toshihiko Shibata, Takashi Murakami, MD, phD, Yosuke Takahashi, MD, phD, Hiromichi Fujii, MD, phD, Akimasa Morisaki, MD, phD, Shunsuke Nishimura, Kokoro Yamane.
Osaka City University, Osaka, Japan.
OBJECTIVE: We experienced minimally invasive mitral and tricuspid valve repair in a patient of situs inversus totalis.
METHODS: A 70 year-old-male with severe mitral valve regurgitation and tricuspid valve valve regurgitation referred out hospital. He had chronic atrial fibrillation for long time. The echocardiography showed functional mitral regurgitation caused by annular dilatation due to the giant left atrium. Anterior leaflet (A3) was prolapse slightly due to elongation of chordae. Moderate tricuspid regurgitation was detected. Minimally invasive surgery though a 8-cm incision was performed. Ascending aortic cannulation was done because of the atherosclerosis of the peripheral arteries. Mitral valve repair was done with loop technique and annuloplasty ring implantation. Since a reversed-use of a 3D-shaped tricuspid annuloplasty ring was not suitable, we used a flexible total annuloplasty ring with running suture technique for tricuspid annuloplaty.
RESULTS: Postoperative course was uneventful and the echocardiography showed satisfactory repair with tiny regurgitation.
CONCLUSIONS: Mitral and tricuspid valve repair can be safely done in minimally invasive surgery. The selection of the tricuspid annuloplasty ring has to be considered.
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