TITLE

MANAGEMENT OF TRICUSPID VALVE REGURGITATION

AUTHOR(S)
Antunes, Manuel J.; Barlow, John B.
PUB. DATE
February 2007
SOURCE
Heart;Feb2007, Vol. 93 Issue 2, p271
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Management of tricuspid regurgitation (TR) is becoming an increasingly difficult decision-making problem. TR occurs in 8–35% of patients, especially in association with acquired left heart valve disease of rheumatic origin, primary isolated TR being very rare. It is more frequently found in association with mitral rather than with aortic valve disease, and is much rarer in degenerative disease. In the majority of patients (70–85%), the TR is said to be ‘functional’, caused by dilatation of the annulus as a result of increased pulmonary and right ventricular pressure; in the remaining 15–30% of the cases it may be organic and related to direct involvement of the tricuspid valve by the rheumatic disease. Whichever type, TR has a significant impact on the clinical condition and the medium and long-term prognosis of the patients. Hence, it requires special consideration during mitral and/or aortic valve surgery and thereafter. In 1967, Brawnwald et al advised a conservative (no touch) approach to TR. Indeed, it was thought that appropriate correction of the left-sided valve disease would most probably result in a decrease or even abolition of the so-called functional TR. However, experience has shown that TR does not always disappear, and may increase, especially when the mitral and/or aortic valve disease is not completely or adequately resolved during surgery, as happens sometimes in cases with less than perfect correction of mitral regurgitation or stenosis. Furthermore, isolated severe TR is now increasingly observed in patients with normal left heart valve function after either mitral valve annuloplasty or replacement. The true incidence of secondary TR is not well known, but it has led some to question the functional nature of TR, accompanying left-sided valve disease. Even moderate TR observed during surgery of left heart valves may not regress spontaneously, especially when there is already a degree of right ventricular dysfunction indicated by annular dilatation. In their experience with patients who were subjected to valvuloplasty for mitral valve regurgitation, Dreyfus et al found that the tricuspid annulus was abnormally dilated in about 50% of the patients, even in the absence of TR.
ACCESSION #
23912834

 

Related Articles

  • Combined mitral and aortic valve repair in a patient with end-stage renal disease. �zbek, Cengiz; Yetkin, Ufuk; �zcem, Bar�in; Bademci, Mehmet; Y�/4rekli, Ismail; Postaci, Nursen; G�/4rb�/4z, Ali // Internet Journal of Thoracic & Cardiovascular Surgery;2009, Vol. 13 Issue 2, p24 

    Mortality in patients with end-stage renal disease is higher than in those with normal renal function after a cardiac operation. Mitral valve repair and if possible aortic valve repair are the procedures of choice to treat valvular dysfunction. We present in this study; combined mitral and...

  • Architectural Trends in the Human Normal and Bicuspid Aortic Valve Leaflet and Its Relevance to Valve Disease. Aggarwal, Ankush; Ferrari, Giovanni; Joyce, Erin; Daniels, Michael; Sainger, Rachana; Gorman, Joseph; Gorman, Robert; Sacks, Michael // Annals of Biomedical Engineering;May2014, Vol. 42 Issue 5, p986 

    The bicuspid aortic valve (AV) is the most common cardiac congenital anomaly and has been found to be a significant risk factor for developing calcific AV disease. However, the mechanisms of disease development remain unclear. In this study we quantified the structure of human normal and...

  • Bicuspid aortic valve disease. Losenno, Katie L.; Chu, Michael W. A. // CMAJ: Canadian Medical Association Journal;12/10/2013, Vol. 185 Issue 18, p1599 

    The article focuses on bicuspid aortic valve disease, the most common congenital heart disease in developed countries. Topics discussed include the disease's higher occurrence in men, its possible association with other heart and aorta abnormalities, and valvular and aortic complications among...

  • Pulsed Doppler Assessment of Tricuspid Regurgitation: Usefulness of Regurgitant Signal Patterns for Estimation of Severity. Carreras, F.; Borrás, X.; Augé, J. M.; Pons-Lladó, G. // Angiology;Sep1988, Vol. 39 Issue 9, p788 

    A study on the value of pulsed Doppler in the detection and quantitative assessment of tricuspid regurgitation (TR) has been conducted on 33 consecutive adult patients with valvular heart disease. Only 1 patient had to be excluded owing to a technically inadequate Doppler examination. Data for...

  • Observation for mildly symptomatic normal-flow, low-gradient severe aortic stenosis: caution advised. Adamo, Luigi; Braverman, Alan C. // Heart;Sep2015, Vol. 101 Issue 17, p1349 

    The bicuspid aortic valve (BAV) affects 1-2% of the population and may be associated with important valvular disease and an increased risk of aortic root and/or ascending aortic aneurysm and dissection. BAV aortic aneurysm and dissection occur earlier in life than when these disorders are...

  • Oral session V.  // European Journal of Echocardiography;2008, Vol. 9 Issue suppl_1, pS77 

    The article presents abstracts on medical topics including determinants of tricuspid annular plane systolic excursion (TAPSE) in heart failure (HF), right ventricular dilatation in mitral valve repair among patients with impaired left ventricular systolic function, and prognosis of pulmonary...

  • Long-term prognosis of mild functional tricuspid regurgitation after mitral valve replacement. Gürsoy, Mete; Bakuy, Vedat; Can Hatemi, Ali; Bulut, Gülsüm; Kılıçkesmez, Kadriye; İnce, Nurhan; Küçükoğlu, Serdar // Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi;Feb2014, Vol. 14 Issue 1, p34 

    Objective: Functional tricuspid regurgitation (FTR) is the most common type of tricuspid insufficiency and occurs approximately in 30% of patients with mitral valve disease. The major etiologic factor in the triggering of right ventricular dilation and thus causing functional tricuspid...

  • A rare case of double orifice mitral valve with flail leaflet with embryological significance -- A case report. Kumar, G. P.; Shaffiuddin, M. // Bangladesh Journal of Medical Science;Jan2014, Vol. 13 Issue 1, p80 

    Mitral valve having a double orifice opening into the left ventricle is an uncommon anomaly, In this case study we describe about a 25 years old female who came to cardiology outpatient block with exertional dysnea, the abnormality was suspected by a murmur, further investigation Colour Doppler...

  • Update on mitral valve prolapse. Hines, Silvia E. // Patient Care for the Nurse Practitioner;Mar2000, Vol. 3 Issue 3, p35 

    Presents information on mitral valve prolapse. Diagnosis; Management; Complications. INSETS: Epidemiology;Why prophylaxis?;Prevalence of MVP in a community cohort.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics