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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 1212-1217, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Role of the septal leaflet in tricuspid valve closure. Consideration for treatment of complete atrioventricular canal

M Higashidate, K Tamiya, H Kurosawa and Y Imai
Department of Pediatric Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.

A septal leaflet of the tricuspid valve is thought to work differently from other anterior and posterior leaflets. We studied its role in valve closure in dogs by means of a dynamic area meter. During the control state, the tricuspid valve orifice area increased twice in diastole coincidentally with either atrial systole or rapid ventricular filling. We observed several findings after the septal leaflet resection: (1) two peak area patterns of the tricuspid valve orifice in diastole, (2) no elevation of right atrial pressure on ventricular systole (there was no V wave), (3) no tricuspid valve regurgitation on right ventriculography. These findings suggest that a complete valve closure occurred without the septal leaflet in regular sinus rhythm. An elevation of the right ventricular pressure produced by pulmonary artery stenosis without septal leaflet, however, easily caused tricuspid valve regurgitation in contrast to the same pressure of the right ventricle with the normal tricuspid valve. The right ventricular pacing caused severe valve regurgitation without the septal leaflet. Results indicate that in the repair of the complete atrioventricular canal defect and other tricuspid valve lesions, the septal leaflet of the tricuspid valve rarely requires attention. An atrioventricular block should be avoided, however, because electrical cardiac pacing on the right ventricle causes severe valve regurgitation without the septal leaflet.

This article has been cited by other articles:

				M. Higashidate, K. Tamiya, T. Beppu, and Y. Imai REGULATION OF THE AORTIC VALVE OPENINGIn vivo dynamic measurement of aortic valve orifice area J. Thorac. Cardiovasc. Surg., August 1, 1995; 110(2): 496 - 503. [Abstract] [Full Text]