Other Types of Heart Valve Surgery

Tricuspid valve insufficiency is the most common disease of the tricuspid valve in Germany. In most cases, the condition is caused by dilation of the ring of connective tissue or a rupture of the delicate chords of the tricuspid valve. If the myocardium is damaged, the leaflets may also be displaced, resulting in tricuspid valve insufficiency. In the majority of cases, tricuspid valve insufficiency can be treated by repairing the damage; this is also known as reconstruction.

Tricuspid valve insufficiency often occurs in combination with mitral valve insufficiency. Both heart valves can be operated on using a minimally invasive procedure.

If tricuspid valve insufficiency is diagnosed and surgery recommended, we conduct another detailed examination using ultrasound or TEE. An assessment will then be made of whether or not the tricuspid valve can be repaired (tricuspid valve reconstruction). This is performed with minimally invasive keyhole surgery. After conducting a number of tests and talking to the individual patient, the surgeon will decide which repair method to use. Only the most advanced and patient-friendly procedures are used at Leipzig Heart Center. If additional heart surgery is required, you may instead undergo a conventional heart operation which involves opening the breastbone.

On the day of your admission to a general ward, you will be questioned in detail, your paperwork will be examined, and any outstanding tests will be conducted, e.g. blood tests, X-rays or ultrasound examinations. Once all of your paperwork and tests are complete, you will discuss the operation you require with the surgeon and the anesthetist. The operation will take place the next day under general anesthesia. The tricuspid valve is typically accessed by making a small incision on the right-hand side of the chest. You will then be connected to the heart-lung machine, and your heart stopped. The heart-lung machine is connected via the right groin. During tricuspid valve reconstruction, the natural geometry of the tricuspid valve is restored. This usually means suturing a synthetic C-shaped band into place. Once the tricuspid valve has been tested to ensure it is functioning well, the heart-lung machine is disconnected and the skin carefully closed. When the anesthetic wears off, you will wake up in the recovery room. For the next 24 hours you will be monitored in our intermediate care ward, before being transferred to the general ward. You will normally spend seven days in hospital.

If it is only the tricuspid valve which is affected, then your operation at the Heart Center in Leipzig will always use a patient-friendly, minimally invasive procedure which involves accessing the valve via the right-hand side of the chest (keyhole surgery). Our clinic at the Heart Center in Leipzig was partly responsible for developing this technique. In very rare cases (e.g. if there has been earlier injury to or disease of the right lung or other heart surgery), the breastbone must be opened for the operation to proceed.