Shoulder Point Fitting Method as a New Universal Tricuspid Annuloplasty

Approximately half of all tricuspid valves consist of four or more leaflets; however, no previous reports have discussed how to implant an annuloplasty ring in these multi-leaflet valves. We herein define the shoulder point of the tricuspid annulus and the annuloplasty ring and advocate a simple and universal fitting method to avoid deforming the tricuspid valve after ring implantation.