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  tricuspid valve repair for biopsy-induced regurgitation in a heart transplant recipient josé l. Navia1, fernando a. Atik1, pablo ruda vega1, mario garcia2, randall c. Starling2, gonzalo v. Gonzalez-stawinski1, nicholas g. Smedira1, delos m. Cosgrove1 departments of 1thoracic and cardiovascular surgery and 2cardiovascular medicine, the cleveland clinic foundation, cleveland, ohio, usa   tricuspid regurgitation (tr) is a frequent complication after heart transplantation. delivery overnight viagra The etiology of tr is multifactorial, but biopsy-induced flail leaflet is one of the most important mechanisms. order viagra without prescription A 61-year-old woman underwent heart transplant, but experienced several rejection episodes which required multiple surveillance endomyocardial biopsies. At three months after transplant, she required tricuspid valve repair due to symptomatic severe tr. The anterior leaflet was flail, with rupture of primary and secondary chordae. generic viagra no prescription Valve repair was performed with a triple leaflet edge-to-edge technique. generic viagra online pharmacy The procedure consisted of suture fixation of the prolapsed anterior leaflet joining to the septal and posterior leaflets, and placement of a 30-mm annuloplasty ring. cheap viagra The patient was uneventfully discharged home on day 7 with trivial tr. At a four-years post-transplant evaluation, she was in nyha functional class i, with preserved ventricular function and trivial tr. generic viagra online pharmacy She has been followed closely because of post-transplant coronary artery disease. generic viagra online pharmacy The journal of heart valve disease 2004;13:264-267   registered users to view the file in pdf format enter your user details below user id password subscribers you must be a subscriber and registered with the site to view these files. generic viagra online pharmacy If you are a subscriber but have not yet registered with the site please click here. Not yet subscribed? overnight shipping viagra Click here to subscribe using our simple online system  . | home videos studios about solutions got 5min? 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