Tricuspid Valve Repair or Replacement

Tricuspid valve repair and tricuspid valve replacement are surgical procedures to address a damaged or diseased tricuspid valve, one of the heart's four valves crucial for regulating blood flow. Situated between the heart's upper and lower right chambers, the tricuspid valve plays a significant role in directing blood flow in the correct direction. A compromised tricuspid valve can disrupt the proper blood flow, causing the heart to exert more effort to pump blood to the lungs and the rest of the body. Both tricuspid valve repair and replacement procedures are intended to enhance blood flow and alleviate symptoms associated with heart valve disease. These surgeries can be performed as either open-heart procedures or minimally invasive heart surgeries, and in some cases, catheter-based techniques may be utilized.

Tricuspid Valve Replacement

If the tricuspid valve can't be repaired, surgery may be done to replace the valve. Tricuspid valve replacement surgery may be done as open-heart surgery or minimally invasive surgery.

During tricuspid valve replacement, a surgeon removes the damaged or diseased valve. The valve is replaced with a mechanical valve made from cow, pig, or human heart tissue. A tissue valve is called a biological valve.

Together, you and your healthcare team discuss the risks and benefits of each type of valve to determine the one that's best for you. If you have a mechanical valve, you must take blood thinners for the rest of your life to prevent blood clots. Biological tissue valves don't require lifelong blood thinners. But they can wear down over time and may need to be replaced.

Tricuspid Valve-in-Valve Replacement

If you have a biological tissue tricuspid valve that's no longer working, valve replacement may be done using thin, flexible tubes called catheters instead of open-heart surgery. The doctor inserts the catheter into a blood vessel and guides it to the tricuspid valve. The replacement valve goes through the catheter and is placed into the existing biological valve.

Tricuspid Valve Repair

Heart surgeons typically recommend heart valve repair whenever feasible, as it preserves the natural valve, negating the necessity for valve replacement and potentially safeguarding heart function.

Tricuspid valve repair is commonly performed through open-heart surgery, although minimally invasive procedures may also be an option in some instances. Minimally invasive tricuspid valve repair involves smaller incisions and shorter hospital stays compared to traditional open-heart surgery and can be highly effective. For infants and children with tricuspid valve stenosis, balloon valvuloplasty is a minimally invasive approach where a catheter with an inflatable balloon is used to widen the narrowed valve.

During tricuspid valve repair, a surgeon may address issues such as patching holes, reconnecting leaflets, reshaping or removing excess tissue, replacing cords for support, separating fused flaps, and reinforcing the valve ring.

Risks

Every surgical procedure carries inherent risks. The risks associated with tricuspid valve repair and replacement hinge on several factors, including the specific type of surgery, your overall health condition, and the proficiency of the surgical team. When considering tricuspid valve intervention, seeking treatment at a medical facility with a comprehensive team of heart surgeons and healthcare professionals specializing in heart valve procedures is advisable. Potential risks of tricuspid valve repair and replacement encompass complications such as bleeding, blood clot formation, valve failure, arrhythmias, infection, stroke, and, in severe cases, mortality.

Before the Procedure

A care team member may shave the hair from the body area where the surgical incisions will be made, and typically, a special soap is applied to cleanse your skin and reduce the risk of infection.

During the Procedure

Tricuspid valve repair or replacement may be done as open-heart surgery or as minimally invasive heart surgery. Open-heart surgery involves making a surgical cut, called an incision, through the middle of the chest to reach the heart. Minimally invasive heart surgery involves much smaller incisions than those used in open-heart surgery. Sometimes, tricuspid valve disease may be treated using thin, flexible tubes called catheters.

For most tricuspid valve repair and tricuspid valve replacement surgeries, you get a combination of medicines to put you in a sleep-like state. This is called general anesthesia. You are connected to a heart-lung bypass machine, which keeps blood moving through the body during the surgery.

After the Procedure

Following tricuspid valve repair or replacement surgery, you will typically have a hospital stay of several days, depending on your condition and the specific procedure performed. Throughout your hospitalization, you may receive fluids and medications via an IV, have drainage tubes for urine and fluid from your heart and chest, and undergo various monitoring and care procedures. Your healthcare team will regularly check for infections, monitor vital signs, assist with pain management, encourage mobility through walking exercises, and guide you in breathing exercises for recovery. They will also provide detailed post-operative instructions covering medication regimens, signs of infection, wound care, pain management, and potential side effects of the surgery.

Results

Recovery time from tricuspid valve repair or replacement surgery varies based on the treatment received, any complications, and your pre-surgery health. Your healthcare provider will advise when you can resume daily activities like work, driving, and exercise.

Following the surgery, regular checkups and heart tests will be necessary to ensure the tricuspid valve functions properly. Adopting a heart-healthy lifestyle post-surgery is crucial, including quitting smoking, maintaining a nutritious diet, staying active, managing weight, and reducing stress. Your care team may recommend enrolling in cardiac rehabilitation, a personalized program combining education and exercise to aid your recovery and enhance your overall well-being.