What Is Tricuspid Valve Surgery?
Tricuspid valve surgery treats problems with your tricuspid valve caused by tricuspid valve disease. It can be performed using traditional open-chest or minimally invasive approaches.
What are the options for tricuspid valve surgery?
Your doctor may repair or replace your tricuspid valve, depending on your condition. Your doctor's recommendation is based on many factors, including your general health, the condition of your damaged valve, the presence of other health conditions, and the expected benefits of surgery.
Types of Tricuspid Valve Surgery
Tricuspid Valve Repair
If you have tricuspid valve disease, the preferred treatment is repairing your own valve rather than replacing it. The surgeons at UPMC are experts at tricuspid valve repair, and our team is committed to pursuing a repair whenever possible.
Repairing your valve is less stressful for your heart. Your native valve is also less likely to get infected or cause a clot. If you have a tricuspid valve repair, you do not need to take lifelong blood thinners to prevent stroke.
Tricuspid Valve Replacement
If your tricuspid valve is too damaged to be repaired, your surgeon may remove your damaged tricuspid valve and replace it with a plastic or metal mechanical valve, or a bioprosthetic valve, which is usually made from pig tissue.
Minimally Invasive Treatment for Tricuspid Valve Disease
Our surgeons have the skills and experience required to successfully perform tricuspid valve repair and replacement using advanced minimally invasive techniques. Minimally invasive procedures access your valve through much smaller incisions — without cutting your breastbone and opening your chest. The benefits of these minimally invasive approaches include:
- Less pain.
- Fewer complications.
- Shorter hospital stay.
- Shorter recovery time.
Our surgeons offer the latest minimally invasive treatment options for tricuspid valve disease, including:
- Valvuloplasty — Balloon valvuloplasty is a minimally invasive procedure to repair a narrowed heart valve. During the procedure, a special catheter (hollow tube) is threaded into a blood vessel in your groin and guided into your heart. The catheter, which contains a deflated balloon, is inserted into your narrowed heart valve. Once in place, the balloon is inflated to stretch the valve open, and then removed.
- Intercostal surgical valve replacement (iSVR) — Using the iSVR procedure, your surgeon can repair or replace your tricuspid valve by accessing your heart through the space between your ribs — and without dividing any major muscle groups, ribs, or cartilage.
Conditions we treat with tricuspid valve surgery
Tricuspid valve disease is rare compared to other types of valve disease and can be caused by:
- Tricuspid valve stenosis — Tricuspid valve stenosis is a narrowing or blockage of your tricuspid valve that limits your blood flow.
Tricuspid valve regurgitation is caused by a weakness in the valve that prevents it from closing completely. The blood pumped out by the heart then flows immediately back into the heart after the heart stops squeezing and relaxes.
Why Would I Need Tricuspid Valve Surgery?
If you have been diagnosed with tricuspid valve disease, your doctor may recommend tricuspid valve surgery.
Who’s a candidate for tricuspid valve surgery?
If you have tricuspid valve stenosis or regurgitation that is causing problems with blood flow, you may be a candidate for tricuspid valve surgery. Your doctor will recommend the best approach to treating your condition.
What Are the Risks and Complications of Tricuspid Valve Surgery?
Some people with severe tricuspid valve disease may be at an increased risk of complications or death from tricuspid valve surgery. Tricuspid valve surgery may be a treatment option, but it isn’t right for everyone.
Is tricuspid valve surgery serious?
For many people, tricuspid valve surgery carries a low risk of complications. However, as with any surgery, there are some risks, including:
- Damage to the artery used for insertion of the valve.
- Major bleeding.
- Need for a pacemaker.
- Other serious life-threatening events or even death.
- Stroke.
What Should I Expect from Tricuspid Valve Surgery?
If your doctor recommends tricuspid valve surgery, our team of heart valve experts will start by doing a thorough exam. During your tricuspid valve surgery exam, you'll meet with:
- A heart surgeon.
- An interventional cardiologist.
- Advanced practice providers.
Our experts use the latest diagnostic tests to learn about your heart valve condition, including:
- Cardiac catheterization — This diagnostic procedure involves inserting a tiny, hollow tube (catheter) through a large artery in your leg or arm leading to your heart to provide images of your heart and blood vessels. This procedure is helpful in determining the type and extent of certain valve disorders.
- Chest x-ray — A chest x-ray is a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. An x-ray can show enlargement in any area of the heart.
- CT angiogram — A CT angiogram is an imaging test that looks at the arteries that supply your heart muscle. This test uses a powerful x-ray machine to produce images of your heart and heart vessels.
- Echocardiogram (Echo) — This noninvasive ultrasound test uses sound waves to evaluate your heart's chambers and valves. The echo sound waves create an image on a monitor as an ultrasound transducer is passed over your heart.
- Electrocardiogram (ECG or EKG) — This test records the electrical activity of your heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage.
- Magnetic resonance imaging (MRI) — MRI is a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
- Transesophageal echocardiogram (TEE) — TEE is a form of echocardiography that is performed by inserting a probe with a transducer into your esophagus rather than placing the transducer on your chest, as in a traditional echocardiogram. A TEE provides a clearer image of your heart because the sound waves do not have to pass through skin, muscle, or bone.
- Two-dimensional echocardiogram (2D Echo) — This test uses ultrasound to display a cross sectional "slice" of your beating heart, including the chambers, valves, and the major blood vessels that exit from the left and right part of your heart.
Your doctor may also order other tests, such as:
- An exercise stress test.
- Lung function tests.
- Ultrasound of your carotid artery.
- Bloodwork and urine tests to look for signs of infection prior to valve replacement.
Before: How to prepare for tricuspid valve surgery
Your doctor will explain the tricuspid valve surgery procedure to you and give you a chance to ask questions. To prepare for tricuspid valve surgery, you should:
- Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
- Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
- Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
- Fast for a certain time before the procedure. Your doctor will tell you how long to fast (usually overnight).
- Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.
On the day of your tricuspid valve surgery procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.
After your tricuspid valve procedure, you will stay in the hospital for several nights. Your doctor will let you know how many nights you may expect to stay for the type of procedure you are having.
You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should also arrange for someone to drive you home from the hospital after you are discharged.
How long does tricuspid valve surgery take?
Your tricuspid valve surgery could take as little as an hour or up to several hours, depending on the type of procedure you are having. You should expect to spend 1-2 hours in the recovery room before being transferred to your hospital room.
During your tricuspid valve surgery
Depending on the type of procedure you are having, you may be placed under general anesthesia or connected to a heart-lung bypass machine that will take over the function of your heart and lungs during your operation.
If you are having tricuspid valve repair surgery, your doctor will explain the approach he or she plans to use in more detail before the surgery. The specific approach your doctor recommends will depend on your condition.
During tricuspid valve replacement surgery, your damaged valve will be cut out, and the new valve will be sewn into place. Your doctor may perform a minimally invasive procedure or open-chest surgery, depending on your condition.
Recovery after tricuspid valve surgery
You will be moved to recovery for observation and monitoring when the procedure is completed.
Your doctor will provide more information about your recovery and will let you know when you can resume your normal activities.
If you receive a mechanical tricuspid valve replacement, you will need to take blood-thinning medication after tricuspid valve surgery. Follow your doctor's instructions and go to all your follow-up appointments.
When to call your doctor about tricuspid valve surgery complications
You should call your doctor if you are experiencing any unusual symptoms, including:
- Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
- Burning or pain in your chest.
- Rapid or pounding heartbeat.
- Severe pain, coldness, numbness, or discoloration in the limb where the catheter was inserted.
- A fever of more than 100.0°F.
- New or increasing shortness of breath.
- Difficulty breathing.
- Difficulty swallowing, throat pain, or bloody cough.
- Redness or rash on your chest or back.
What’s the prognosis after tricuspid valve surgery?
Most otherwise healthy people continue to lead active, normal lives after tricuspid valve surgery.
What is the life expectancy after tricuspid valve surgery?
For most people, life expectancy after tricuspid valve surgery is the same as anyone else who does not have heart problems. Talk to your doctor if you have questions about your life expectancy after your tricuspid valve surgery.
What’s the success rate of tricuspid valve surgery?
Tricuspid valve surgery success rates vary depending on the type of procedure you’re having. However, most people who have tricuspid valve surgery have positive outcomes, reduced symptoms, and improved quality of life.
Why Choose UPMC for Tricuspid Valve Surgery?
The surgeons at UPMC provide expert treatment for tricuspid valve disease—including regurgitation and stenosis—with outstanding outcomes. Our specialists are highly trained in the latest and safest minimally invasive techniques for tricuspid valve repair and replacement surgery.
Last reviewed by a UPMC medical professional on 2024-10-01.