The long-term results of a “tighter” tricuspid annuloplasty (TAP) by De Vega's technique for secondary tricuspid regurgitation (TR) were studied. From June 1985 to July 1993, 122 patients underwent TAP following mitral valve surgery in our clinic. The analysis was performed on 50 patients who were followed up for more than 5 years (a mean of 75.1 months ranging from 60 to 96 months). The patients consisted of 13 males and 37 females with a mean age of 53.7 years (range from 28 to 71 years). The echocardiogram taken after long-term follow-up showed that the right ventricular inflow peak velocity at rest was a mean of 0.72m/s ranging from 0.53 to 1.04m/s, while the mean pressure half time was 76.7±14.9msec. Significant residual TR was observed in 16% at 1 month, 6% at 1 year, 10% at 3 years, and 12% at 5 years or more after operations. We conclude that a “tighter” TAP by De Vega's technique for secondary TR seems to be effective for the long-term reduction of residual TR and is not a causative factor for tricuspid stenosis.

A 45-year-old man was admitted with several histories of cerebral infarction. Transesophageal echocardiography showed a small tumor on the anterior mitral leaflet. Open heart surgery was performed. The tumor was removed including a part of the anterior mitral leaflet and mitral valve plasty was done. The post-operative course was uneventful. Papillary fibroelastoma was diagnosed pathologically. To avoid embolic complication, an early surgical procedure is recommended.

A 47-year-old man was admitted with symptoms of angina pectoris. After evaluating the patient, coronary artery bypass grafting (CABG) was performed. First, the left internal thoracic artery (LITA) was grafted to the obtuse marginal branch (OM), and then the right gastroepiploic artery (RGEA) was grafted to the posterior descending branch (PD). Just after completing anastomosis, we performed intraoperative thermal coronary angiography. The RGEA-PD was patent. However, the LITA-OM was not patent on thermal coronary angiography. After a re-anastomosis was done at the LITA-OM, thermal coronary angiography was again performed and the LITA-OM was found to be patent. The postoperative course was uneventful, and all grafts were patent on postoperative angiography. In conclusion, intraoperative thermal coronary angiography was found to be useful for CABG.