Name of the Procedure:

Valvuloplasty, tricuspid valve; with ring insertion (also known as tricuspid valve repair with annuloplasty ring)

Summary

Valvuloplasty with ring insertion is a heart surgery aimed at repairing the tricuspid valve by using a supportive ring to reshape and strengthen it. This procedure helps the valve to close properly and ensures better blood flow.

Purpose

The procedure addresses the issue of tricuspid valve regurgitation, where the valve does not close tightly, causing blood to flow backward in the heart. The goal is to restore normal valve function and improve overall heart efficiency and patient symptoms, such as fatigue and swelling.

Indications

• Severe tricuspid valve regurgitation
• Symptoms include swelling in the legs or abdomen, fatigue, and shortness of breath
• Heart enlargement or heart failure symptoms related to the valve issue
• Ineffectiveness of medications or other less invasive treatments

Preparation

• The patient should fast for at least 8 hours before the procedure.
• Medications might need to be adjusted or stopped, as directed by the healthcare provider.
• Pre-procedure tests might include blood tests, chest X-rays, echocardiograms, and electrocardiograms (ECGs).

Procedure Description

1. The patient is administered general anesthesia to ensure unconsciousness and pain-free status.
2. An incision is made in the chest to access the heart.
3. The surgeon exposes the tricuspid valve and evaluates the extent of damage.
4. A specially designed ring (annuloplasty ring) is sewn around the valve opening to reinforce and reshape it.
5. The valve is tested for proper function before closing the incision.
6. The chest is closed, and the patient is moved to a recovery area.

Tools and Equipment

• Annuloplasty ring
• Surgical instruments for heart valve repair
• Heart-lung bypass machine (if needed)

Anesthesia

General anesthesia is used.

Duration

The procedure typically takes 2 to 4 hours.

Setting

The procedure is performed in a hospital's operating room or specialized cardiac surgical center.

Personnel

• Cardiac surgeon
• Surgical nurses
• Anesthesiologist
• Perfusionist (if heart-lung bypass machine is used)

Risks and Complications

• Common risks: Infection, bleeding, blood clots
• Rare risks: Stroke, heart attack, valve dysfunction, need for a pacemaker
• Complication management: Post-operative monitoring and prompt medical intervention

Benefits

• Improved valve function
• Relief from symptoms like fatigue, swelling, and shortness of breath
• Enhanced quality of life and reduced risk of further heart complications
• Benefits are usually realized within weeks of recovery.

Recovery

• Initial hospital stay of 5-7 days
• Instructions include wound care, medication adherence, and limiting physical activity.
• Full recovery can take several weeks to a few months.
• Follow-up appointments to monitor heart function and overall recovery are necessary.

Alternatives

• Medication management
• Less invasive procedures like percutaneous interventions
• Heart valve replacement surgery
• Pros and cons: Medications may not be effective for severe cases. Replacement surgery is more invasive but may be necessary if the valve is too damaged for repair.

Patient Experience

• The patient will be asleep during the surgery.
• Post-operative discomfort managed with pain medications.
• Experiences may include fatigue and some pain during initial recovery.
• Gradual return to normal activities as the healing progresses, guided by follow-up care instructions.