Illustration of the 'shoulder point fitting' method for tricuspid valve repair

Shoulder Point Fitting: A Simpler Way to Repair Tricuspid Valves?

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"New surgical method offers a universal approach to tricuspid valve annuloplasty, potentially reducing complications and improving patient outcomes."

Tricuspid valve repair is gaining more and more attention. The term 'tricuspid' suggests that the tricuspid valve (i.e., the right-sided atrioventricular valve) has three leaflets. However, about half of all tricuspid valves consist of three leaflets and that the remaining half consist of four or more leaflets. The complexity of tricuspid valve anatomy, especially in cases with multiple leaflets, poses a significant challenge during valve repair surgeries.

A recent study published in The Annals of Thoracic Surgery introduces a novel technique called the 'shoulder point fitting method' for tricuspid annuloplasty. This method aims to simplify the procedure and improve outcomes by providing a universal landmark for surgeons to use during the repair process.

This article breaks down the 'shoulder point fitting method,' its benefits, and why it could become a game-changer in tricuspid valve repair.

What is the 'Shoulder Point Fitting' Method?

Illustration of the 'shoulder point fitting' method for tricuspid valve repair

The 'shoulder point fitting method' focuses on identifying a consistent anatomical landmark on both the tricuspid valve annulus and the annuloplasty ring. This 'shoulder point' serves as a guide for positioning and securing the annuloplasty ring, which is used to reshape and stabilize the valve.

Here's how the method works:

Defining the Shoulder Point: The shoulder point is located on a diagonal line extending from the commissure (the point where valve leaflets meet) between the anterior and septal leaflets.
Locating the Shoulder Point: Imagine the valve as a clock face. If the commissure between the septal and posterior leaflets is at 3 o'clock, the shoulder point is approximately at 2 o'clock.
Adapting to Valve Variations: In valves with multiple leaflets, the shoulder point may be located on the annulus of the posterior leaflet.

By using this shoulder point as a reference, surgeons can more accurately position the annuloplasty ring, regardless of the number of leaflets or variations in valve anatomy. This can lead to a more secure and effective repair, reducing the risk of complications.

Why This Method Matters

The 'shoulder point fitting method' offers several potential advantages over traditional techniques. It simplifies the procedure, making it more accessible to a wider range of surgeons. It also provides a more reliable and consistent approach, regardless of the complexity of the valve anatomy. Finally, it could lead to better patient outcomes by reducing the risk of complications and improving the long-term durability of the repair.

The study authors suggest that this method can be applied to any tricuspid valve morphology, making it a truly universal solution. They also emphasize the importance of using the shoulder point as a guide to avoid distorting the valve during the repair process.

While further research is needed to confirm these benefits, the 'shoulder point fitting method' represents a promising step forward in the field of tricuspid valve repair. For patients with tricuspid valve disease, this new technique could offer a simpler, safer, and more effective path to recovery.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.athoracsur.2018.01.028, Alternate LINK

Title: Shoulder Point Fitting Method As A New Universal Tricuspid Annuloplasty

Subject: Cardiology and Cardiovascular Medicine

Journal: The Annals of Thoracic Surgery

Publisher: Elsevier BV

Authors: Toshihiko Shibata, Yosuke Takahashi, Yoshito Sakon, Akimasa Morisaki, Takashi Murakami

Published: 2018-07-01

Everything You Need To Know

What exactly is the 'shoulder point fitting method'?

The 'shoulder point fitting method' is a novel technique introduced for tricuspid annuloplasty. It focuses on identifying and utilizing a consistent anatomical landmark, the 'shoulder point', on both the tricuspid valve annulus and the annuloplasty ring. This landmark guides surgeons in positioning and securing the ring, which reshapes and stabilizes the valve, leading to a more accurate and effective repair.

Why is the 'shoulder point fitting method' considered important?

The 'shoulder point fitting method' is important because it simplifies the complex procedure of tricuspid valve repair, making it more accessible and reliable. The method is designed to be adaptable, regardless of the number of leaflets or variations in the valve's anatomy. This offers the potential for better patient outcomes by reducing complications and improving the long-term effectiveness of the repair. The existing repair techniques face challenges due to the anatomical complexity of the tricuspid valve. The 'shoulder point fitting method' addresses these issues by providing a universal landmark.

How is the 'shoulder point' identified and located in the 'shoulder point fitting method'?

The 'shoulder point' is located on a diagonal line extending from the commissure, where the tricuspid valve leaflets meet, between the anterior and septal leaflets. Imagine the valve as a clock face. If the commissure between the septal and posterior leaflets is at 3 o'clock, the 'shoulder point' is approximately at 2 o'clock. The method adapts to variations; for valves with multiple leaflets, the 'shoulder point' may be located on the annulus of the posterior leaflet. This approach is crucial for standardizing the procedure across different valve anatomies.

What are the potential advantages of the 'shoulder point fitting method'?

The 'shoulder point fitting method' offers several potential advantages. It simplifies the surgical process making the procedure more accessible to a wider range of surgeons. It provides a more reliable and consistent approach regardless of the complexity of the valve anatomy. The ultimate goal is to reduce the risk of complications and improve the long-term durability of the repair, potentially leading to improved patient outcomes.

What are the broader implications of using the 'shoulder point fitting method'?

The implications of the 'shoulder point fitting method' are significant for tricuspid valve repair. By simplifying the procedure and offering a standardized approach, it could revolutionize the treatment of tricuspid valve disease. The method could potentially reduce the need for complex and time-consuming procedures. This could lead to faster recovery times and improved quality of life for patients. The widespread adoption of this method could also lead to a better understanding of the tricuspid valve anatomy and its repair.