Totally Endoscopic Tricuspid Ring Annuloplasty On Beating Hearts In Combination With Atrial Septal Defect Repair: Feasible Technique
Huy Q. Dang, Ngoc M. Nguyen.
Hanoi Heart Hospital, Hanoi, Viet Nam.
Objectives: To investigate the effectivity and safety of totally endoscopic tricuspid ring annuloplasty technique on beating hearts in combination with atrial septal defect (ASD) repair. Methods: Twenty-four patients (39-71 years, mean 52.2 ± 12.3) underwent ASD closure and tricuspid ring annuloplasty on beating hearts by a totally endoscopic approach. All of them had moderate to severe tricuspid valve regurgitation (TVR) with mean pulmonary artery pressure (PAP) was 61.8 ± 10.89 mmHg. Cardiopulmonary bypass (CPB) was achieved peripherally. Three 5-mm trocars and one 12-mm trocar were used; only the superior vena cava is snared, filling the pleural and pericardial cavities with CO2. Results: Tricuspid ring placement was successful in all cases. No extension of the incision was needed. Mean bypass time was 90.2 ± 12.04 min. After surgery, there were 15 cases with non-trivial TVR and 9 cases with mild TVR. Postoperative mean PAP was 28.4 ± 12.19 mmHg. No arrhythmia or AV block was recorded. Conclusions: Tricuspid ring annuloplasty in non-robotic totally endoscopic ASD closure on beating hearts is a safe and efficient technique. 
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