MANAGEMENT OF ISOLATED TRICUSPID VALVE ENDOCARDITIS – EXPERIENCE OF A TERTIARY CARE CENTER.

Aims: To evaluate surgical management outcomes of tricuspid valve endocarditis at our hospital. Material And Methods: An observational study was conducted at ABVIMS and DR RML Hospital, New Delhi, between April 2019 and April 2024 on patients who underwent cardiac surgery. Inclusion criterion was patients with having isolated tricuspid valve endocarditis who were willing for vegetectomy. Exclusion criterion was presence of other cardiac conditions like valvular diseases other than isolated tricuspid valve endocarditis, coronary artery disease, congenital heart diseases. Vegetectomy was performed with adequate margins to remove all infective foci. The valve was reassessed, and reconstruction was planned. Small leaet defects were repaired with pericardial patches, while excised leaets were replaced with neoleaets made from autologous pericardium. Residual tricuspid regurgitation was checked via saline insufation and transesophageal echocardiography. Limited annuloplasty with pericardium managed regurgitation, ensuring proper leaet coaptation. After successful tricuspid repair, the right atrium was closed, and the patient was weaned off cardiopulmonary bypass. The outcome measures were change in severity of tricuspid regurgitation (TR). Bhapkar test was used for statistical analysis with p<0.05 as level of signicance. Results: Total eight patients were included, with mean age being 25.62±10.73 years. Six (75%) were females and two (25%) were males. The vegetation size varied from 0.5 cm to 2 cm. Blood culture showed Staphylococcus aureus in 4 cases, Enterococci in 1 case, M. tuberculosis in single case and two cases were sterile. Preoperatively, there were 7 severe cases, and 1 moderate case of TR. Signicant improvement was seen postoperatively, as there was only one severe case, two moderate cases, and ve mild cases of TR (P<0.0001). Conclusion: To conclude, surgical management of isolated tricuspid valve endocarditis is either elective or emergent in our study we concluded that better give 4 weeks antibiotics and take on elective basis and simple vegetectomy give best results. Clinical signicance: This study highlights rarity of isolated tricuspid valve endocarditis (5-10%) especially in Indian population where IV drug abuse is rare. Tailored structural approach for each tricuspid lesion offer best therapeutic management