Right ventricular papillary muscle approximation for functional tricuspid regurgitation associated with severe leaflet tethering.

Recurrent tricuspid regurgitation (TR) can occur after tricuspid annuloplasty if severe leaflet tethering persists. To reduce the tethering, we applied right ventricular papillary muscle approximation in 7 patients with severe functional TR associated with significant leaflet tethering. Postoperative echocardiogram revealed mild or less TR and a significant reduction in the tethering effect. In conclusion, this adjunctive technique can improve functional TR associated with leaflet tethering.