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General Thoracic and Cardiovascular Surgery

20-04-2024 | Special Edition

Current management of tricuspid regurgitation: a focus on the spiral suspension approach

Authors: Kiyoyuki Eishi, Junichiro Eishi, Ichiro Matsumaru, Mizuki Sumi, Kikuko Obase, Takashi Miura

Published in: General Thoracic and Cardiovascular Surgery

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Abstract

The indication for surgery for tricuspid regurgitation (TR) has reached a major turning point. It has become clear that the presence of moderate or severe TR alone worsens the prognosis of life, and the previous guidelines of Japanese Circulation Society, in which the indication for surgery was recommended at the timing of “right heart failure difficult to treat medically,” now recommends surgery with a trigger of “repeated right heart failure” in the 2020 edition. In addition, a new repair technique targeting at subvalvular structure has been developed for end-stage TR to overcome a high TR recurrence rate that is associated with severe right ventricular enlargement and leaflet tethering. This review focuses on the spiral suspension technique, in which the papillary muscles are spirally suspended towards the septal leaflet annulus to correct tethering and enhances the understanding of its application in the context of TR management.
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Metadata
Title
Current management of tricuspid regurgitation: a focus on the spiral suspension approach
Authors
Kiyoyuki Eishi
Junichiro Eishi
Ichiro Matsumaru
Mizuki Sumi
Kikuko Obase
Takashi Miura
Publication date
20-04-2024
Publisher
Springer Nature Singapore
Published in
General Thoracic and Cardiovascular Surgery
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-024-02024-y