Journal articles: 'Valva Tricuspide'

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Das, Debasish, Nishant Debta, and Manas Ranjan Mohapatra. "Myxomatous Tricuspid Valve." Journal of Cardiovascular Medicine and Surgery 4, no. 1 (2018): 60–61. http://dx.doi.org/10.21088/jcms.2454.7123.4118.10.

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McElhinney, Doff B., Norman H. Silverman, Michael M. Brook, Frank L. Hanley, and Paul Stanger. "Asymmetrically short tendinous cords causing congenital tricuspid regurgitation: improved understanding of tricuspid valvar dysplasia in the era of color flow echocardiography." Cardiology in the Young 9, no. 3 (May 1999): 300–304. http://dx.doi.org/10.1017/s1047951100004972.

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AbstractBackgroundTricuspid regurgitation as a manifestation of an isolated congenital anomaly of the tricuspid valve is rare. Cross-sectional and color Doppler echocardiography allow improved evaluation of tricuspid valvar function. As a result, the heterogeneous category of congenital tricuspid valvar dysplasia may be better understood from a functional point of view. We are reporting a distinct entity in which tricuspid valvar regurgitation results from failure of coaptation due to short tendinous cords tethering the septal leaflet.Patients and ResultsThree children with significant primary tricuspid regurgitation were evaluated, treated, and followed. On echocardiographic evaluation, a central regurgitant jet of moderate or severe degree was directed toward the atrial septum through poorly coapting tricuspid valvar leaflets, which did not approximate due to tethering of the septal leaflet by abnormally short cords. In one patient, the tricuspid valve was otherwise normal; in the other two the leaflets and cords were also thickened. Two patients underwent surgery at 9 and 11 years of age. The cords tethering the septal leaflet were augmented by interposing appropriate lengths of expanded polytetrafluoroethylene suture and performing commissural annuloplasty. Both patients are asymptomatic 33 and 42 months postoperatively, with mild residual tricuspid regurgitation that has not changed since surgery. The other patient, an 8 month-old infant, has not yet undergone surgery.ConclusionsAsymmetric tendinous cords of the tricuspid valve causing tethering of the septal leaflet is a distinct cause of tricuspid regurgitation that can be recognized with echocardiography. Although rare, the importance of recognizing this lesion lies in its being readily amenable to surgical repair.

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Mortazavi, Ali, Ross M. Reul, Leon Cannizzaro, and Kathryn G. Dougherty. "Transvenous Transcatheter Valve-in-Valve Implantation after Bioprosthetic Tricuspid Valve Failure." Texas Heart Institute Journal 41, no. 5 (October 1, 2014): 507–10. http://dx.doi.org/10.14503/thij-14-4302.

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We describe the case of a 38-year-old man with a history of metastatic testicular cancer who had undergone multiple thoracic surgical procedures, including tricuspid valve replacement with a bioprosthetic valve as a result of tricuspid involvement of his malignancy. He presented at our outpatient cardiology clinic with worsening fatigue, shortness of breath, and peripheral edema, investigation of which revealed severe tricuspid bioprosthesis stenosis with central regurgitation. Because of the patient's medical history, he was considered to be a high-risk surgical candidate. Therefore, transcatheter tricuspid valve-in-valve implantation of a 26-mm Edwards Sapien® valve was attempted through a transjugular approach. The procedure restored tricuspid valvar competence and substantially improved the patient's symptoms. We discuss the technical aspects of this case and briefly review the usefulness of the valve-in-valve technique in the tricuspid position.

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Wong, Kenny K., Duncan I. Farquharson, and Walter J. Duncan. "Unguarded tricuspid valvar orifice in the fetus." Cardiology in the Young 14, no. 5 (October 2004): 557–59. http://dx.doi.org/10.1017/s1047951104005141.

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The unguarded tricuspid valve is uncommon. We describe herein a fetus with a grossly dilated right ventricle and atrium, with severe tricuspid and pulmonary valvar regurgitation. The right ventricle was akinetic, and no tricuspid tissue or valvar apparatus was identified. Colour Doppler showed a highly unusual retrograde flow of blood through the right heart. The pregnancy was terminated, and necropsy examination confirmed the gross dilation of the right heart chambers, with severely dysplastic valvar tissue at the right atrioventricular junction effectively giving an unguarded orifice. There was no valvar displacement, and the left heart was normal. The fetus had a normal karyotype, albeit with absent kidneys.

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El Asmar, Bechara, Michael Acker, Jean Paul Couetil, P. H. Penther, and Alain Carpentier. "Tricuspid valve myxoma: A rare indication for tricuspld valve repair." Annals of Thoracic Surgery 52, no. 6 (December 1991): 1315–16. http://dx.doi.org/10.1016/0003-4975(91)90020-q.

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Du, Zhong-Dong, Nathan Roguin, Mila Barak, and Elliot Milgram. "Prevalence of valvar regurgitation by color Doppler echocardiography in neonates with normal hearts." Cardiology in the Young 6, no. 3 (July 1996): 216–21. http://dx.doi.org/10.1017/s1047951100003693.

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AbstractValvar regurgitation has been commonly found by echocardiography in adults and older children with normal hearts, but there is limited knowledge in neonates. To evaluate the prevalence of valvar regurgitation and analyze risk factors, echocardiography was performed on 975 consecutive neonates (1–7 days of age) with normal hearts. Regurgitation was detected and graded with pulsed, continuous-wave and color Doppler imaging techniques. Thirty-five cases with valvar regurgitation were followed for one month. The results showed that 369 (37.8%) neonates had evidence of regurgitation in one or more valves. Tricuspid regurgitation was most commonly found and was detected in 345 (35.4%) neonates, mitral regurgitation in 51 (5.2%), pulmonic regurgitation in 25 (2.6%), and aortic regurgitation in eight (0.8%). Most of them were trivial or mild and involved just one valve. Moderate or severe regurgitation was detected only in the tricuspid valve (3%) and the mitral valve (0.1 %). Five (0.5%) neonates with severe tricuspid regurgitation had heart murmurs, and two (0.2%) of them presented with cardiorespiratory distress. The risk factors for tricuspid and mitral regurgitation included lower chronologic age, gestational age and whether the neonates had a patent arterial duct; whereas those for tricuspid regurgitation also related to lower Apgar scores, birth weight and whether the neonates had a patent oval foramen. About 90% of the tricuspid regurgitation disappeared and the remaining 10% decreased in one month. We concluded that trivial or mild valvar regurgitation is commonly found in neonates with normal hearts. Moderate or severe regurgitation is relatively rare and occurs only in the tricuspid and mitral valves with a few cases causing clinical attention.

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Bharucha, Tara, Robert H. Anderson, Zek S. Lim, and Joseph J. Vettukattil. "Multiplanar review of three-dimensional echocardiography gives new insights into the morphology of Ebstein’s malformation." Cardiology in the Young 20, no. 1 (January 19, 2010): 49–53. http://dx.doi.org/10.1017/s1047951109991971.

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AbstractIntroductionWe aimed to assess the ability of the multiplanar review modality of three-dimensional echocardiography to examine the dynamic morphology and the functional characteristics of malformed tricuspid valves in patients previously identified as having Ebstein’s malformation. Based on these characteristics, we attempted to differentiate Ebstein’s malformation from tricuspid valvar dysplasia.MethodsUsing three-dimensional multiplanar review, analysed with either Qlab 6.0 or Tomtech Image Arena 3.0, we studied 23 patients, aged from 1 day to 70 years, previously diagnosed using cross-sectional echocardiography as having Ebstein’s malformation.ResultsUsing the features of rotational abnormality, and the orientation, of the effective tricuspid valvar orifice as diagnostic features of Ebstein’s malformation, we reclassified 11 patients (48 per cent) as exhibiting tricuspid valvar dysplasia. In addition, we studied the dynamic morphology as well as the function of the tricuspid valve. Surgical treatment was undertaken on 10 patients, revealing good correlation with the findings obtained using three-dimensional multiplanar review. In those with Ebstein’s malformation, we found varying degrees of rotation, with the effective valvar orifice always directed towards the right ventricular outflow tract. The opening of the orifice of dysplastic tricuspid valves, in contrast, was towards the apex of the right ventricle. The degree of delamination, and abnormalities of subcordal apparatus, were similar in the two groups.DiscussionThree-dimensional multiplanar review permits accurate definition of the dynamic morphology of Ebstein’s malformation, permitting clear differentiation from tricuspid valvar dysplasia.

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Pinto, Robin J., Jaya Deshpande, and Bharat V. Dalvi. "Mitral value anomalies in tricuspid atresia: an autopsy study of 54 hearts." Cardiology in the Young 7, no. 2 (April 1997): 163–71. http://dx.doi.org/10.1017/s1047951100009410.

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AbstractAnatomic study of 54 autopsied cases of tricuspid atresia revealed mitral valvar anomalies in 9 (16.7%). The morphologic findings in these 9 cases are presented and compared with 45 cases having a normal mitral valvar apparatus. The anomalies included a cleft valve in 2, parachute valve in 2, straddling valve in 3, and a valve with dual orifice in 2.Two of these cases had more than one anomaly. Data from echocardiography and cardiac catheterisation, when available, had failed to diagnose the anomalies during life. The anomalies were more commonly associated with discordant ventriculo-arterial connections (33.3% versus 13.3%, p < 0.01), were associated significantly with a large ventricular septal defect (33.3% versus 4.4%, p < 0.01), and with pulmonary hypertension (33.3% versus 2.2%, p < 0.01). Two of 3 post operative deaths among the 9 were due to hemodynamic consequences arising from the uncorrected mitral valvar anomaly (parachute valve in both ). Diagnosis of these anomalies prior to surgical correction is imperative, as their presence may necessitate repair or replacement of the mitral valve. Failure to do so may result in increased perioperative mortality, congestive cardiac failure and arrhythmias at a later date. Mitral valvar anomalies may be a contributory factor to the early onset of cardiac failure seen in patients with tricuspid atresia undergoing palliative shunts.

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Serraf, Alain, Richard A. Jonas, Redmond P. Burke, Aldo R. Castaneda, and John E. Mayer. "Univentricular repair for complex double right ventricle and transposed great arteries." Cardiology in the Young 7, no. 2 (April 1997): 207–14. http://dx.doi.org/10.1017/s1047951100009483.

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AbstractThe Fontan operation was initially designed to provide a “physiological correction” of tricuspid atresia, but its indications have been extended to more complex forms of congenitally malformed hearts. In selected patients with two adequately sized ventricles, but highly complex intra cardiac anatomy which makes a biventricular repair more hazardous and which would require multiple reoperations, a univentricular repair using Fontan's principle has been proposed. Between 1978 and 1992, a modified Fontan operation was carried out in 34 such patients. Of the patients. 13 had double outlet right ventricle and 21 had transposed great arteries. Anomalies of ventricular loop were present in 14 patients. A non-committed ventricular septal defect was found in 26 whilst multiple defects were present in 10. All patients had anomalies of the atrioventricular valves, with straddling of the tricuspid valve,11and/or of the mitral valve11, and abnormal tricuspid5, or mitral4cordal attachments. Two patients had mild tricuspid hypoplasia, 1 had mitral hypoplasia and 3 had a cleft mitral valve. Fourteen patients had anomalies of both atrioventricular valve but only 6 had mild atrioventricular valvar incompetence. Pulmonary stenosis or atresia was seem in 26. All the patients had at least one or more (mean 2.35) intracardiac anomalies that preculded a biventricular repair. The Fontan operation was performed at a median age of 4.75 years. There were 4 early (11.4%, 70% CL: 5.1–19.8) and 2 late deaths, with a 4 year actuarial survival rate of 79.6±8.1%. Univariate analysis did not reveal any risk factor for early of late death. Follow-up at a mean interval of 3.6 ±2.6 years was available in all but 1 survivor. There were 6 early and 2 late reoperations, and 3 patients required implantation of a pacemaker. In conclusion, the modified Fontan operation can provide satisfactory early and mid term results in patients with two ventricles but with complex intracardiac anatomy which precludes a biventricular repair.

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Radford, Dorothy J., R. Bruce Garlick, and Peter G. Pohlner. "Multiple valvar replacements for hypereosinophilic syndrome." Cardiology in the Young 12, no. 1 (January 2002): 67–70. http://dx.doi.org/10.1017/s1047951102000136.

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A boy with familial eosinophilia had the hypereosinophilic syndrome, with involvement of mitral and tricuspid valves. Between the ages of 11 and 20 years, he underwent eight surgical procedures on his atrioventricular valves. The pathology included recurrent thrombotic vegetative masses related to hypereosinophilia. Initial repair of the mitral valve was shortlived, but recurrent repairs of the tricuspid valve were helpful. Mechanical prostheses inserted in the mitral position thrombosed despite anticoagulant therapy, and bioprosthetic valves deteriorated with thrombus, fibrosis, or tearing. The hypereosinophilic syndrome is unusual in children, and produces additional problems with valvar surgery.

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Schenk, Marty, Leon M. Gerlis, and Jane Somerville. "Clinicopathological correlation—a case of complex congenitally corrected transposition." Cardiology in the Young 4, no. 3 (July 1994): 238–43. http://dx.doi.org/10.1017/s1047951100011124.

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SummaryA 29-year-old man, with a diagnosis of congenitally corrected transposition (discordant atrioventricular and ventriculoarterial connections) with associated multiple ventricular septal defects, mild pulmonary valvar stenosis and Ebstein's malformation of a stenotic left-sided morphologically tricuspid valve, died after closure of the ventricular septal defect and insertion of a valved homograft conduit between the morphologically left ventricle and the pulmonary trunk. Death occurred because of failure to appreciate the bizarre and rather stenotic anomaly of the morphologically tricuspid valve, in which the anterosuperior leaflet divided the morphologically right ventricle into an inlet portion and a smaller outlet portion. After closure of the ventricular septal defects, this ventricle could no longer support the systemic circulation. We discuss the natural history and the reasons for the erroneous interpretation of the echocardiographic images of the left-sided tricuspid valve.

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Gerlis, L. M., R. Egdell, and Jane Somerville. "Congenitally corrected transposition presenting at 24 years: errors of management." Cardiology in the Young 7, no. 4 (October 1997): 465–70. http://dx.doi.org/10.1017/s1047951100004534.

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AbstractA 24-year-old female without previous symptoms or known heart disease consulted a general practitioner with dyspnoea which had slowly worsened over a period of two years. She was treated for asthma, without investigations, until she presented with rapid atrial fibrillation, chest pain and pulmonary oedema necessitating admission to hospital, where she was found to have “mitral” regur-gitation (of the left-sided atrioventricular valve) and congenitally corrected transposition. At operation the grossly regurgitant left-sided morphologically tricuspid valve was replaced by a “top-hat” inverted aortic valve homograft. The procedure resulted in intermittent heart block, needing a pacemaker, and continued myocardial failure which progressed with new right-sided valvar regurgitation. She died a few months later. Post mortem examination confirmed the double discordance, and showed a fistula around the tricuspid valvar prosthesis, left atrial thrombus and changes in the mitral valve. There was also an unsuspected area of old myocardial ischaemia, associated with severe hypoplasia of the circumflex branch of the right-sided coronary artery. This was considered probably to have been of embolic origin.

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D, Kishore Naick, Sreekanth C, Thyagaraju K, and Subhadra Devi Velichety. "MORPHOMETRY OF TRICUSPID VALVE IN HUMAN FOETAL CADAVERS." International Journal of Anatomy and Research 3, no. 2 (June 30, 2015): 1114–20. http://dx.doi.org/10.16965/ijar.2015.173.

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Ishibashi, Nobuyuki, Mitsuru Aoki, and Tadashi Fujiwara. "Double switch operation in a young infant." Cardiology in the Young 14, no. 6 (December 2004): 661–63. http://dx.doi.org/10.1017/s1047951104006110.

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We performed a combined Senning and arterial switch operation on a 2-month-old patient with congenitally corrected transposition, Ebstein's malformation producing severe tricuspid regurgitation, ventricular septal defect, pulmonary hypertension, and congestive heart failure. The tricuspid regurgitation was improved. The double switch operation has the advantage of improving the function of the systemic atrioventricular valve, especially in newborns or young infants in whom the outcome of the valvar repair is poor.

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Chiappa, Enrico, Piero Gaglioti, and Tullia Todros. "Prenatal diagnosis of tricuspid valvar dysplasia and regurgitation—always a poor outcome?" Cardiology in the Young 5, no. 4 (October 1995): 338–44. http://dx.doi.org/10.1017/s1047951100002808.

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AbstractThe anatomic and pathophysiologic features of tricuspid valvar dysplasia are discussed in the light of two cases observed during fetal life which progressed with an unexpectedly favorable course. Some fetal echocardiographic features are proposed to explain this outcome. First, absence of associated cardiovascular abnormalities; second, clear separation between well represented right ventricular walls and the tricuspid valvar leaflets; third, normal proximal insertion of the tricuspid leaflets and, fourth, normal dimensions of the pulmonary trunk. We recommend karyotyping because of the possible association of this malformation with an aneuploid karyotype. We also describe transitory functional atresia of the pulmonary valve at birth, as far as we know for the first time, in a neonate that had normal forward flow of blood as seen on Doppler sampling in fetal life.

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Allen, Margaret D., Frank Slachman, A. Craig Eddy, Daniel Cohen, Catherine M. Otto, and Alan S. Pearlman. "Tricuspid valve repair for tricuspid valve endocarditis: Tricuspid valve “recycling”." Annals of Thoracic Surgery 51, no. 4 (April 1991): 593–98. http://dx.doi.org/10.1016/0003-4975(91)90317-j.

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Asante-Korang, Alfred, Patrick W. O'Leary, and Robert H. Anderson. "Anatomy and echocardiography of the normal and abnormal mitral valve." Cardiology in the Young 16, S3 (September 2006): 27–34. http://dx.doi.org/10.1017/s1047951106000734.

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Unlike the tricuspid valve, the mitral valve has frequently received the attention of anatomists. Indeed, the drawings made by Leonardo da Vinci still retain their currency,1whilst it was no less a personage than Andreas Vesalius who, as far as we know, first likened the bifoliate appearance of the valve to the Episcopal mitre. It was also Vesalius who recommended that the two leaflets be described as aortic and mural, reflecting their respective relationships to the aortic valve and the parietal atrioventricular junction. It was Roberts and Perloff,2however, who emphasized the necessity, for clinical purposes, of analyzing not only the valvar leaflets, but also the overall valvar complex. As we will demonstrate in our review, this approach to analysis also proves its worth for the echocardiographic recognition of the congenitally malformed valve.

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Chaudhary, Kirti, Monalisa Roy, and Mahesh Shinde. "Cadaveric Study on Papillary Muscles of Human Tricuspid Valve." Indian Journal of Anatomy 6, no. 1 (2017): 71–74. http://dx.doi.org/10.21088/ija.2320.0022.6117.13.

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Pradhan, S., N. C. Gautam, Y. M. Singh, S. Shakya, R. B. Timala, J. Sharma, and B. Koirala. "Tricuspid Valve Repair: Devega’s Tricuspid Annuloplasty in Moderate Secondary Tricuspid Regurgitation." Kathmandu University Medical Journal 9, no. 1 (June 7, 2012): 64–68. http://dx.doi.org/10.3126/kumj.v9i1.6266.

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Background Moderate secondary tricuspid incompetence has variable natural history if left unattended during mitral valve surgery. Recent data suggest progression of the secondary tricuspid incompetence over time. Secondary moderate tricuspid regurgitation in rheumatic mitral valve disease may regress after mitral valve surgery without direct intervention. Objectives: The present retrospective comparative hospital based tudy was done to assess early result of DeVega tricuspid valve annuloplasty amongst those with moderate tricuspid regurgitation due to rheumatic mitral valve disease. Methods: Group I (mitral valve replacement with tricuspid repair) and Group II (mitral valve replacement only) were compared regarding functional class, heart rate, rhythm, cardiac dimensions, function and valve pathology. The two groups were followed up at three months post-operatively and evaluated for their functional class and echocardiography variables. The data was analyzed with SPSS 16.0 Results: There were 43 patients who underwent mitral valve replacement with moderate tricuspid regurgitation. Twenty three underwent mitral valve replacement with tricuspid repair group (Group 1). Most of the patients were women (28/43). The mean age was 31.4 + 14.8 and 25.13 + 9.4 years. Group I had 21(91.3%) and Group II had 17 (85%) in NYHA class III & IV. The pre-operative echocardiographic cardiac left ventricular and left atrial dimensions, left ventricular function and valve lesions were statistically similar for both groups, except PASP was higher amongst tricuspid repair (Group 1: 38.60 + 12.75mHg, Group 2: 61.52 + 19.76mmHg; p= <0.05). At three month’s review after surgery, four patients were in NYHA II amongst those without tricuspid repair (Group II), whilst the rest were in NYHA I. Left ventricular dimensions, Left Ventricular function and valve prosthetic valve function were similar between groups. Eleven (47.8%) patients in Group I and only five (25%) of Group II had trace or less TR at the follow-up (p < 0.05). There were 7 (16.2%) patients who had persistent moderate TR. Higher PASP and larger LV dimensions at three months were predictive of persistent moderate TR. Conclusion Mitral valve replacement does decrease the severity of tricuspid regurgitation amongst those with secondary moderate tricuspid regurgitation by at least one grade, but DeVega’s annuloplasty confers a better repair result. http://dx.doi.org/10.3126/kumj.v9i1.6266 Kathmandu Univ Med J 2011;9(1):64-8

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Ada, Fatih, Kemalettin Ucanok, Ahmet Ruchan Akar, Mustafa Bahadir Inan, Serkan Durdu, Mustafa Sirlak, Levent Yazicioglu, Adnan Uysalel, and Sadik Eryilmaz. "Effects of Preoperative Tricuspid Valve Diameters on Early Postoperative Surgical Outcomes in Patients Undergoing Tricuspid Valve Surgery." Heart Surgery Forum 20, no. 4 (August 24, 2017): 142. http://dx.doi.org/10.1532/hsf.1842.

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Background: Many of the previous studies on tricuspid valve surgery were on the materials that were used and the advantages and disadvantages of them. In this study, effects of preoperative tricuspid valve diameter on early postoperative outcomes were investigated. Methods: A total of 43 patients who underwent tricuspid valve repair surgery with the ring between the years 2012-2014 were included in this study. Tricuspid valve diameters and other cardiac functions of patients undergoing tricuspid intervention were evaluated with transthoracic echocardiography.Patients included in this study were divided into 2 groups: those with minimal, minimal-to-1st degree and 1st-degree tricuspid valve regurgitation found on thoracic echocardiography in the early postoperative period were considered as having a successful tricuspid repair (Group 1). Those with 1st-2nd degree and higher degrees of tricuspid regurgitation were considered as having an unsuccessful tricuspid repair (Group 2).The relationship between tricuspid valve dimensions and early tricuspid valve regurgitation was assessed with the help of preoperative, intraoperative, and postoperative data.Results: Thirty patients (Group 1) were found to have a successful tricuspid valve repair in the postoperative period. The mean annulus diameter of the tricuspid valve at end-diastole in patients from Group 1 was similar to Group 2 (4.24 ± 0.44 cm versus 3.99 ± 0.40; P = .080). Also, tricuspid valve end-systolic diameter in Group 1 was similar to patients in Group 2 (3.59 ± 0.38 cm versus 3.42 ± 0.33 cm; P = .151). Conclusion: A direct relationship was not found between tricuspid valve diameter and post-operative development of moderate to severe regurgitation in tricuspid valve surgery in this study.

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Al Jubair, Khalid A., Abdullah Jaralla, Mohsen Fadala, Emad Bukhari, Yahya Al Faraidi, Huwaida Al Qethami, and Mohamed R. Al Fagih. "Repair of the mitral valve because of pure rheumatic mitral valvar incompetence in the young." Cardiology in the Young 8, no. 1 (January 1998): 90–93. http://dx.doi.org/10.1017/s1047951100004698.

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AbstractBetween January 1985 and April 1994, 42 children aged between 7 and 14 years (mean 11.3 years) underwent repair of severely incompetent rheumatic mitral valves with no accompanying mitral stenosis. In 19 patients the tricuspid valve was severely incompetent, while 8 patients had severe aortic incompetence. Overall, the repair incorporated shortening of elongated tendinous cords and insertion of a Duran or Carpentier prosthetic ring. The repair was the sole procedure in 15 patients, whilst 19 patients also had a De Vega tricuspid valvar annuloplasty and 8 had repair or replacement of the aortic valve. There were no hospital deaths. Postoperative transthoracic echocardiographic studies revealed trivial residual mitral valvar regurgitation in 6 patients, mild regurgitation in 18, moderate in 15, and regurgitation severe enough to warrant replacement of the mitral valve in 3 patients. The mean follow-up period was 37 months (maximum 120 months, minimum 1 month). 0139 patients followed-up, 28 attended for more than 5 years. Of these, 7 underwent replacement of the mitral valve for severe regurgitation within 4 years of the repair. Severe mitral regurgitation in 3 patients was controlled by medical therapy. One was eventu ally lost to follow-up, and one patient died of causes unrelated to surgery. The remaining 16 patients had absent to moderate mitral valvar regurgitation. These results contrast with 10 repairs of congenital mitral incompetence, where no patients required re-operation in the immediate 5 years period of follow-up. Every effort should be made in children with rheumatic mitral incompetence to preserve the natural valve by con servative repair, despite the fact that repair of the incompetent rheumatic mitral valve is not so durable as repair of congenitally incompetent valves.

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Rigby, Michael L., Micelia Salgado, and Celia Silva. "Determinants for outcome of hypoplastic right ventricle with duct-dependent pulmonary blood flow presenting in the neonatal period." Cardiology in the Young 2, no. 4 (October 1992): 377–81. http://dx.doi.org/10.1017/s1047951100007976.

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SummaryA retrospective study was undertaken of patients with hypoplastic right ventricles, either with pulmonary atresia and intact ventricular septum or critical pulmonary valvar stenosis, and duct-dependent pulmonary blood flow who were investigated at the Royal Brompton Hospital between January 1976 and December 1990. The diagnosis was made on the basis of at least one diagnostic method (cross-sectional echocardiography, cardiac catheterization and angiography, or autopsy). Of the patients, 56 (82%) were found to have an imperforate pulmonary valve or infundibulum (pulmonary atresia), while 12(18%) had critical pulmonary valvar stenosis. The ratio of the diameters of the tricuspid and mitral valvar orifices was measured angiographically during diastole, and the right ventricle was analyzed according to the presence or overgrowth of the inlet, apical trabecular and outlet components. A correlation was made between the severity of the disease and the outcome. The overall mortality was 53% when those not undergoing any surgery were excluded, and significant differences were found between the group dying and those who survived. The incremental risk factors for death were a ratio between the diameter of the tricuspid and mitral valves of less than 0.6; the presence of fistulous communications with the coronary arteries; and obliteration of the apical trabecular component of the right ventricle. There was no significant difference between the group with pulmonary valvar atresia and the group with critical stenosis of the pulmonary valve.

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Baria, Kinnaresh, Jignesh Kothari, Sanjay Patel, and Yogini Kandre. "Evaluation of Outcomes of Tricuspid Valve Flexible Ring Annuloplasty with Left Sided Heart Valve Surgery." Journal of Cardiovascular Medicine and Surgery 4, no. 4 (2018): 261–69. http://dx.doi.org/10.21088/jcms.2454.7123.4418.1.

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N, Balachandra, and Ramesh B R. "A STUDY OF THE DIMENSIONS OF THE HUMAN TRICUSPID VALVE." International Journal of Anatomy and Research 6, no. 3.3 (September 5, 2018): 5652–59. http://dx.doi.org/10.16965/ijar.2018.303.

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Bettegowda, Shruthi, Vimala Sheshadri Iyenga, Shivaranjan Kambadahalli Pillappa, and Phani Konide. "Isolated tricuspid valve prolapse with rheumatoid arthritis: an unusual association." Asian Pacific Journal of Health Sciences 1, no. 4 (October 2014): 500–501. http://dx.doi.org/10.21276/apjhs.2014.1.4.33.

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Dearani, Joseph A., Patrick W. O'Leary, and Gordon K. Danielson. "Surgical treatment of Ebstein's malformation: state of the art in 2006." Cardiology in the Young 16, S3 (September 2006): 12–20. http://dx.doi.org/10.1017/s1047951106000710.

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Ebstein's malformation is a congenital anomaly of the tricuspid valve and right ventricle that is characterized by several features, each of which can exhibit a spectrum of malformation. The first is adherence of the leaflets of the tricuspid valve to the underlying myocardium, this representing failure of delamination during development. This feature involves the septal and inferior leaflets, but rarely the anterior leaflet (Fig. 1). The second feature is anterior and apical rotational displacement of the functional annulus (Fig. 2). The third abnormality is dilation of the “atrialized” portion of the right ventricle, with variable degrees of hypertrophy and thinning of the wall. The fourth finding is redundancy, fenestrations, and tethering of the anterior leaflet. A fifth abnormality is dilation of the right atrioventricular junction, this being the true tricuspid valvar annulus. The final feature is variable ventricular myocardial dysfunction. Each heart with Ebstein's malformation is different, and there is an infinite variability that can occur with the above mentioned characteristics. These anatomical and functional abnormalities cause important tricuspid regurgitation, which results in right atrial and right ventricular dilation, and atrial and ventricular arrhythmias.

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RAMAN, S., E. SPARKS, H. BOUDOULAS, and C. WOOLEY. "Tricuspid valve disease: Tricuspid valve complex perspective." Current Problems in Cardiology 27, no. 3 (March 2002): 103–42. http://dx.doi.org/10.1016/s0146-2806(02)70012-1.

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Raman, Subha V., Elizabeth A. Sparks, Harisios Boudoulas, and Charles F. Wooley. "Tricuspid valve disease: Tricuspid valve complex perspective." Current Problems in Cardiology 27, no. 3 (March 2002): 103–42. http://dx.doi.org/10.1067/mcn.2002.123262.

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Knight-Mathis, Vicki, Carol M. Cottrill, and Robert K. Salley. "Accessory tissue tags arising from the mitral valve—an unusual cause of ventricular flow obstruction." Cardiology in the Young 4, no. 2 (April 1994): 175–77. http://dx.doi.org/10.1017/s1047951100002158.

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SummaryAccessory atrioventricular valvar tissue is uncommon and, on occasion, has been identified as a cause of ventricular outflow obstruction. Accessory tricuspid valvar tissue has been reported to cause subpulmonary obstruction but infrequently has accessory tissue arising from the mitral valve been associated with obstruction. This paper reports two cases of subvalvar obstruction; the first in association with a ventricular septal defect causing subaortic obstruction and the other in association with congenitally corrected transposition and a ventricular septal defect, causing subpulmonary obstruction.

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Small, Adam J., Olcay Aksoy, Daniel S. Levi, Morris M. Salem, Eric H. Yang, and Jamil A. Aboulhosn. "Combined Transcatheter Tricuspid and Pulmonary Valve Replacement." World Journal for Pediatric and Congenital Heart Surgery 11, no. 4 (July 2020): 432–37. http://dx.doi.org/10.1177/2150135120918777.

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Background: For patients with combined tricuspid and pulmonary valve disease, operative intervention carries high mortality risk. Published reports of combined transcatheter tricuspid and pulmonary valve replacement have been limited to single cases. Methods: A retrospective chart review was performed including all patients undergoing combined transcatheter tricuspid and pulmonary valve replacement at the Ahmanson/UCLA Adult Congenital Heart Disease Center. Results: Combined transcatheter tricuspid and pulmonary valve replacement was undertaken in five adult patients (median age: 46 years; range: 24-64 years). Three had congenital heart disease and two had carcinoid syndrome. Four patients had previous surgical tricuspid valve replacement and one had a surgical incomplete annuloplasty ring. Four patients had previous surgical pulmonary valve replacement and one had a right ventricle-to-pulmonary artery homograft conduit. Two patients underwent Medtronic Melody valve implantation in both tricuspid and pulmonary positions and three underwent Edwards Sapien S3 implantation in both tricuspid and pulmonary positions. Valve implantation was successful in all. Follow-up ranged from 0.9 to 3.0 years. One patient underwent redo transcatheter tricuspid valve replacement 12 months after the first transcatheter intervention for progressive regurgitation of a Melody valve. This patient died 2.5 years after combined valve placement of complications from refractory heart failure. The remaining patients were alive and free of valve reintervention at follow-up. Conclusions: Combined transcatheter tricuspid and pulmonary valve replacement can be performed successfully, with an acceptable complication rate. This strategy is a feasible option for appropriately selected patients.

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Karciauskas, Dainius, Vaida Mizariene, Povilas Jakuska, Egle Ereminiene, Paulius Orda, Rasa Ordiene, Jolanta Justina Vaskelyte, Irena Nedzelskiene, Sarunas Kinduris, and Rimantas Benetis. "Early and long-term results of aortic valve sparing aortic root reimplantation surgery for bicuspid and tricuspid aortic valves." Perfusion 34, no. 6 (March 2019): 482–89. http://dx.doi.org/10.1177/0267659119831926.

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Introduction: To evaluate early and long-term clinical outcomes following aortic valve sparing aortic root reimplantation surgery in patients with leaking bicuspid and tricuspid aortic valves. Methods: The study consisted of 92 consecutive adult patients (tricuspid aortic valve group = 63 and bicuspid aortic valve group = 29) who underwent aortic valve sparing aortic root reimplantation surgery with or without aortic cusp repair for dilatation of the aortic root and/or aortic valve regurgitation at our institution from April 2004 to October 2016. Clinical outcomes were investigated using Kaplan–Meier and log-rank tests between groups. Results: The follow-up was 100% complete with a mean time of 5.3 ± 3.3 years. The 30-day in-hospital mortality was 3.1% in tricuspid aortic valve group and 3.4% in bicuspid aortic valve group patients. The overall survival rates at 10 years did not differ between bicuspid aortic valve and tricuspid aortic valve patient groups (96.6 ± 3.3% vs. 90.3 ± 4.2%, p = 0.3). Freedom from recurrent aortic valve regurgitation (>2+) at 10 years was 90.5 ± 4.1% in tricuspid aortic valve group and 75.7 ± 8.7% in bicuspid aortic valve group (p = 0.06). Freedom from aortic valve reoperation at 10 years was 100% in tricuspid aortic valve group and 83.9 ± 7.4% in bicuspid aortic valve group (p = 0.002). Conclusion: Aortic valve sparing aortic root reimplantation surgery is a safe and efficient technique, providing acceptable long-term survival with low rates of valve-related complications in both tricuspid aortic valve and bicuspid aortic valve patient groups. However, aortic valve reoperation rates at 10 years follow-up were higher in bicuspid aortic valve group patients compared to tricuspid aortic valve group patients.

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Martinez, Richard M., Patrick W. O'Leary, and Robert H. Anderson. "Anatomy and echocardiography of the normal and abnormal tricuspid valve." Cardiology in the Young 16, S3 (September 2006): 4–11. http://dx.doi.org/10.1017/s1047951106000709.

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Perhaps because it guards the inlet to the lesser circulation, the morphologically tricuspid valve has received less attention in terms of its anatomy than the well-explored mitral valve, which will receive attention in a subsequent review in this supplement.1 As we will show in our initial review, nonetheless, the approach to morphological analysis is the same for both valves, irrespective of whether the specific morphology is displayed in the autopsy room or the echocardiographic laboratory. It is essential that the valve be analysed so as to reveal the precise structure of each if its components – the so-called valvar complex.2 Equally important, in the current era, with the burgeoning use of three-dimensional displays that place the heart firmly within the context of the body, it is essential that the components of the valve be described as seen relative to the bodily axis,3 rather than following the present custom of describing the heart as though it is removed from the body and positioned on its own apex.

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Álvarez-Fuente, Maria, Nikolaus A. Haas, and Maria Jesus del Cerro. "Edwards valve-in-valve implantation in tricuspid position." Cardiology in the Young 27, no. 8 (May 16, 2017): 1633–36. http://dx.doi.org/10.1017/s1047951117000786.

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AbstractWe present two cases of percutaneous Sapien XT valve-in-valve implantation in the tricuspid position: a 20-year-old man with severe congenital pulmonary stenosis and percutaneous valvuloplasty, who required surgical implantation of two protheses, pulmonary and tricuspid, and a 12-year-old boy with CHD and a degenerated tricuspid prosthesis. We implanted three Sapien XT valve-in-valves, two in the tricuspid position and one in the pulmonic position. Sapien XT valve-in-valve implantation in the tricuspid position is feasible and can decrease the number of surgeries in CHD patients.

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Tinica, Grigore, Igor Nedelciuc, Iulian Rotaru, Flavia Catalina Corciova, Dumitru Grajdianu, Andrei Tarus, Mihail Enache, Raluca Ozana Chistol, Maria Luiza Cobzeanu, and Cristina Furnica. "Transcatheter Tricuspid Valve-in-Valve Replacement by Transatrial Approach." Applied Sciences 10, no. 18 (September 18, 2020): 6540. http://dx.doi.org/10.3390/app10186540.

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Reoperation on the tricuspid valve after prior heart valve surgery is associated with an increased operative risk due to a poor clinical status with severe heart failure and late presentation. Transcatheter tricuspid valve-in-valve implantation emerged as an attractive alternative to a high-risk redo surgery. The authors report a case of successful treatment of a failed bioprosthetic tricuspid valve in a 58-year-old woman with severe heart failure, decompensated cardiac cirrhosis and atrial fibrillation using transcatheter tricuspid valve-in-valve implantation of a Sapien 3 valve (Edwards Lifesciences, Irvine, California) via a transatrial approach. This case demonstrates the efficiency of this novel approach for the treatment of dysfunctional surgical tricuspid bioprosthetic valves and the technical feasibility and safety of a rarely used route.

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B. R, Harsha, and Chandrashekar K.T. "CADAVERIC STUDY ON ANTERIOR AND POSTERIOR PAPILLARY MUSCLES OF TRICUSPID VALVE." International Journal of Anatomy and Research 3, no. 1 (February 28, 2015): 865–68. http://dx.doi.org/10.16965/ijar.2015.103.

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Wanjari, Anil, Swapnil Chillawar, Sourya Acharya, and S. N. Mahajan S N Mahajan. "Congenital Tricuspid Valve Dysplasia with Infective Endocarditis Presenting as Cardiac Tamponade." Indian Journal of Applied Research 3, no. 8 (October 1, 2011): 538–39. http://dx.doi.org/10.15373/2249555x/aug2013/171.

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Athavale, Sunita, Rashmi Deopujari, Urmila Sinha, Rekha Lalwani, and Sheetal Kotgirwar. "Is tricuspid valve really tricuspid?" Anatomy & Cell Biology 50, no. 1 (2017): 1. http://dx.doi.org/10.5115/acb.2017.50.1.1.

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Hanna, Nader, Andres Carmona, Hector Crespo, and Roberto J. Cubeddu. "Mechanical tricuspid balloon ‘valvuloplasty’ in a prohibitive risk patient with cardiogenic shock: a case report." European Heart Journal - Case Reports 4, no. 3 (May 3, 2020): 1–4. http://dx.doi.org/10.1093/ehjcr/ytaa086.

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Abstract Background We present a complex case of a failing tricuspid mechanical valve prosthesis in a patient with refractory cardiogenic shock at prohibitive risk for surgery in whom balloon ‘valvuloplasty’ resulted in immediate haemodynamic improvement in valve function. Case summary A 67-year-old woman with remote history of endocarditis s/p tricuspid valve repair and mechanical aortic valve replacement was referred for second opinion and management of new severe symptomatic tricuspid valve stenosis resulting in progressive debilitating congestive heart failure (HF). The patient was approved by the heart team to undergo redo open heart for surgical repair of the tricuspid valve. Intraoperative technical challenges were met to repair the tricuspid valve. In turn, the native valve was resected and a 33 mm On-X mechanical valve prosthesis. The patient’s post-operative course was complicated by recurrent haemoptysis, prolonged mechanical respiratory support, acute kidney injury, and cardiogenic shock. Surgical re-exploration to address the dysfunctional mechanical tricuspid valve was felt to be prohibitive. Structural heart team was consulted. Cardiac catheterization was recommended to ascertain and confirm findings. The patient was transferred to the cardiac catheterization laboratory. Initial fluoroscopic examination of the heart confirmed the echocardiographic results of an immobile septal leaflet of the recently implanted mechanical tricuspid valve. An 8 × 40 mm Mustang OTW angioplasty balloon was then advanced across the mechanical valve and inflated gradually at nominal pressure. A single inflation resulted in successful restoration of valve leaflet function. Discussion To the best of our knowledge, this is the first balloon ‘valvuloplasty’ on a mechanical On-X valve in the tricuspid position.

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Kowalska, Wiktoria, Ewa Jędrzejczyk-Patej, Aleksandra Konieczny, Jonasz Kozielski, Maciej Bugajski, Aleksandra Woźniak, Oskar Kowalski, and Beata Średniawa. "Medtronic Micra leadless pacemaker implantation to patient with artificial tricuspid valve." In a good rythm 4, no. 45 (December 29, 2017): 16–19. http://dx.doi.org/10.5604/01.3001.0010.7492.

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In case of the need of pacemaker implantation, patients with artificial tricuspid valve are a special group of subjects, because of high risk of dysfunction of the prosthesis. In case of mechanical prosthesis of tricuspid valve the leads of pacemaker are usually located in coronary sinus. In case of biological prosthesis of tricuspid valve despite of the risk of prosthesis damage the electrodes are implanted endocardially. The leadless pacemakers seems to be promising alternative in patients with artificial tricuspid valve because of minor risk of valve damage. The case report concerns to the patient with tachycardia-bradycardia syndrome and biological prosthesis of tricuspid valve in whom the leadless pacemaker Micra was implanted.

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Reichart, Daniel, Niklas Schofer, Florian Deuschl, Andreas Schaefer, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, and Lenard Conradi. "Transcatheter Tricuspid Valve-In-Ring and Aortic Valve-In-Valve Implantation." Thoracic and Cardiovascular Surgeon Reports 06, no. 01 (January 2017): e29-e31. http://dx.doi.org/10.1055/s-0037-1606345.

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Background Transcatheter heart valve (THV) therapies have shown to be an alternative to surgical valve replacement, especially in high-risk patients requiring redo surgery. However, reports of transcatheter-based interventions in tricuspid valve position are scarce. Case Description Here, we report a case of successful concomitant transcatheter aortic valve-in-valve (ViV) and tricuspid valve-in-ring (ViR) procedures using a 23-mm CoreValve Evolut R THV (Medtronic, Inc., Minneapolis, Minnesota, United States) in aortic position and a 29-mm SAPIEN3 (Edwards Lifesciences, Inc., Irvine, California, United States) THV in tricuspid position. Conclusion This case demonstrates feasibility of concomitant transcatheter aortic ViV and tricuspid ViR procedures.

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Ivanovic-Krstic, Branislava, Dimitra Kalimanovska-Ostric, Bosiljka Vujisic-Tesic, Dragana Jovanovic, Predrag Petrovic, and Danica Cvetkovic-Matic. "Cardiac echinococcosis." Srpski arhiv za celokupno lekarstvo 130, no. 5-6 (2002): 217–21. http://dx.doi.org/10.2298/sarh0206217i.

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Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm) in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

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Freund, Matthias, Achim Magener, and Klaus G. Schmidt. "Discordant atrioventricular and ventriculoarterial connections with partially unguarded left-sided atrioventricular orifice and aortic atresia." Cardiology in the Young 7, no. 4 (October 1997): 450–53. http://dx.doi.org/10.1017/s1047951100004492.

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AbstractCongenitally unguarded morphologically tricuspid valvar orifice is a rare abnormality, usually associated with pulmonary atresia. We describe such a case found in association with discordant atrioventricular and ventriculoarterial connections in which the aortic valve was atretic. Presentation was with respiratory distress due to severe cardiac failure after birth. Echocardiography demonstrated a dilated systemic ventricle with poor function, left atrial enlargement, and aortic atresia. The clinical findings were confirmed at autopsy.

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Aboulhosn, Jamil A., Ronald J. Oudiz, Amish S. Dave, Abbas Ardehali, and David J. Ross. "Successful Tricuspid Valve Replacement in a Patient with Severe Pulmonary Arterial Hypertension and Preserved Right Ventricular Systolic Function." Case Reports in Medicine 2009 (2009): 1–4. http://dx.doi.org/10.1155/2009/108295.

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A 56-year-old patient with severe pulmonary hypertension developed severe tricuspid regurgitation, right-sided heart failure, and congestive hepatopathy. She was transferred for possible lung transplant and/or tricuspid valve surgery. Clinical and echocardiographic assessment provided confidence that acute tricuspid valve failure was responsible for the decompensation and that tricuspid valve replacement despite pulmonary hypertension could be performed.

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van Son, Jacques AM, Jörg Hambsch, Michael D. Black, and Friedrich W. Mohr. "Chordal Replacement in Tricuspid Valve Repair in Children." Asian Cardiovascular and Thoracic Annals 6, no. 1 (March 1998): 45–48. http://dx.doi.org/10.1177/021849239800600110.

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Congenital or traumatic tricuspid regurgitation in the pediatric population, although generally well tolerated initially, may lead ultimately to right atrial and ventricular dilation and dysfunction with dysrhythmias. In order to preserve right atrial and ventricular function and maintain sinus rhythm, it is our objective to repair the regurgitant tricuspid valve at an early stage. In 5 children (mean age 8.8 years) with congenital tricuspid regurgitation (2 with Ebstein's anomaly, 1 each with ventricular septal defect, tetralogy of Fallot, and partial agenesis of chordae), and in 1 child with traumatic tricuspid regurgitation, the shortened (n = 4), congenitally absent (n = 1), and ruptured (n = 1) chordae tendineae of the anterior or septal leaflets or both, were repaired with polytetrafluoroethylene artificial chordae. The tricuspid valve was successfully reconstructed in all 6 patients. De Vega's (n = 3) or Danielson's (n = 2) plication of the tricuspid valve annulus was performed in 5 patients. At a mean follow-up time of 15.7 months, tricuspid valve function was normal in 2 patients and the other 4 had mild residual tricuspid regurgitation. The mean diameter of the tricuspid annulus decreased from 36.7 mm preoperatively to 30.0 mm postoperatively, which is in the range for children with a normal tricuspid valve. In congenital or traumatic tricuspid regurgitation, chordal replacement using polytetrafluoroethylene artificial chordae is a useful adjunct to the armamentarium of tricuspid valve repair. Early repair avoids deterioration of right atrial and ventricular function and promotes maintenance of sinus rhythm.

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Liu, Peng, Dong-Sheng Xia, Wei-Hua Qiao, Dan Hu, Adnan Ahmed, Nian-Guo Dong, and Si Chen. "Which is the best prosthesis in an isolated or combined tricuspid valve replacement?" European Journal of Cardio-Thoracic Surgery 59, no. 1 (October 13, 2020): 170–79. http://dx.doi.org/10.1093/ejcts/ezaa273.

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Abstract OBJECTIVES The debate concerning the optimal choice of tricuspid position continues. We compared the long-term results of mechanical and biological prostheses in patients who underwent isolated or combined tricuspid valve replacement, at 2 major cardiac surgical centres in central China. METHODS From January 1999 to December 2018, 338 patients underwent tricuspid valve replacement. Patients were divided into an isolated group or a combined group according to whether their surgery was combined with a left heart valve surgery. Mechanical tricuspid valve replacement was performed in 142 patients (isolated group: 41 vs combined group: 101), and 196 patients underwent bioprosthetic tricuspid valve replacement (isolated group: 145 vs combined group: 51). Operative results, long-term survival and tricuspid valve-related events were compared. RESULTS Early mortality in the combined group was higher (n = 6, 4%) than that in the isolated group (n = 3, 2%), but no significant difference was observed between the mechanical and biological subgroups. In the isolated group, there was a higher event-free rate in the biological subgroup than in the mechanical subgroup (P = 0.042) and a similar result was also observed for patients without Ebstein’s anomaly (P = 0.039). In the combined group, no significant difference was observed (P = 0.98). Survival rates were similar between the mechanical and biological subgroups in both the isolated (P = 0.54) and combined (P = 0.81) groups. Mechanical valves in isolated tricuspid valve replacement were more prone to valve thrombosis and bleeding. CONCLUSIONS Every decision regarding tricuspid valve prostheses should be individualized, but biological prostheses may be an optimal choice for patients, especially for patients without Ebstein’s anomaly, in isolated tricuspid valve replacement.

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Džiugas, Gediminas, Kęstutis Ručinskas, Palmyra Semėnienė, Karolina Džiugienė, Arimantas Grebelis, and Vytautas Sirvydis. "Intraveninių narkomanų triburio vožtuvo izoliuoto infekcinio endokardito chirurginio gydymo patirtis." Lietuvos chirurgija 8, no. 3 (January 1, 2010): 0. http://dx.doi.org/10.15388/lietchirur.2010.3.2107.

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Gediminas Džiugas1, Kęstutis Ručinskas1 , Palmyra Semėnienė1, Karolina Džiugienė2, ArimantasGrebelis1, Vytautas Sirvydis1 1 Vilniaus universiteto Širdies ir kraujagyslių ligų klinika, Santariškių g. 2, LT-08661 VilniusEl. paštas: gdziugas@gmail.com2 Vilniaus universiteto Medicinos fakultetas Įvadas: Mažiausiai 5 % triburio vožtuvo (TV) infekcinio endokardito (IE) atvejų reikia gydyti chirurgiškai. Nėra daug studijų, analizuojančių intraveninių narkomanų izoliuoto triburio vožtuvo infekcinio endokardito chirurginio gydymo rezultatus. Duomenų apie tokių ligonių gydymą Lietuvoje nėra. Mes pateikiame pastarųjų 10-ies metų rezultatus, gydant intraveninius narkomanus, operuotus dėl triburio vožtuvo infekcinio endokardito. Įvertinome triburio vožtuvo protezavimo biologiniu vožtuvu ir plastikos ankstyvuosius bei vėlyvuosius rezultatus. Ligoniai ir metodai: Ši studija retrospektyvi. Atlikta 18 ligonių, operuotų Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centre dėl izoliuoto triburio vožtuvo infekcinio endokardito 2000–2010 m., duomenų analizė. Visi ligoniai vartojo intraveninius narkotikus. Rezultatai: Pooperaciniu laikotarpiu nemirė nė vienas ligonis, visi išrašyti iš stacionaro. Ankstyvųjų pooperacinių komplikacijų pasitaikė tik ligoniams, kuriems atliktas triburio vožtuvo protezavimas (4 iš 14 pacientų). Tačiau skirtumas, palyginti su triburio vožtuvo plastikos grupe, nereikšmingas (p=0,225). Ilgesnė hospitalizacijos trukmė buvo po TV protezavimo biologiniu protezu (27,7±14,5 d.) nei po TV plastikos (18,7±15,1 d.). Vėlyvosios komplikacijos išsivystė 8 ligoniams: septyniems buvo atliktas pirminis TV protezavimas biologiniu vožtuvu ir vienam – TV plastika. Keturiems ligoniams buvo infekcinio endokardito atkrytis. Vėlyvuoju pooperaciniu laikotarpiu mirė 4 (22 %) ligoniai. Išvados: Daliai intraveninių narkomanų triburio vožtuvo chirurginė korekcija yra vienintelis veiksmingas triburio vožtuvo infekcinio endokardito gydymo būdas. Po triburio vožtuvo protezavimo biologiniu protezu dažnai būna ankstyvųjų ir vėlyvųjų komplikacijų. Triburio vožtuvo plastika – saugesnis gydymo būdas ankstyvuoju pooperaciniu laikotarpiu. Reikšminiai žodžiai: triburis vožtuvas, intraveninių narkotikų vartojimas, infekcinis endokarditas, triburio vožtuvo plastika, triburio vožtuvo protezavimas, komplikacijos The experience of surgery for isolated tricuspid valve infective endocarditis in intravenous drug abusers Gediminas Džiugas1, Kęstutis Ručinskas1 , Palmyra Semėnienė1, Karolina Džiugienė2, ArimantasGrebelis1, Vytautas Sirvydis1 1 Vilniaus universiteto Širdies ir kraujagyslių ligų klinika, Santariškių g. 2, LT-08661 VilniusEl. paštas: gdziugas@gmail.com2 Vilniaus universiteto Medicinos fakultetas Objective: Tricuspid valve infective endocarditis usually affects intravenous drug users. At least 5% of patients with tricuspid valve infective endocarditis have to be treated surgically. Few data exist on surgery for the isolated tricuspid valve infective endocarditis in intravenous drug abusers, and there is no such data in Lithuania. This study summarizes our experience in a surgical treatment of isolated tricuspid valve infective endocarditis in intravenous drug users. Patients and methods: This is a retrospective analysis of 18 patients operated on for isolated tricuspid valve infective endocarditis in our centre in 2000–2010. All the patients were intravenous drug abusers. Results: There were no perioperative deaths. Early complications were observed only in the tricuspid valve replacement group (4/14), but there was no significant difference (p = 0.225) was compared to the reconstruction group. There was a longer hospitalization period (27.7 ± 14.5 d) for tricuspid valve replacement than for tricuspid valve reconstruction (18.7 ± 15.1 d.). Eight patients had late complications, of them seven had undergone initial tricuspid valve replacement and one – reconstruction. Four patients had recurrent endocarditis. Late mortality was in 4 (22 %) patients. Conclusion: For some intravenous drug abusers, tricuspid valve surgery for tricuspid valve infective endocarditis is the only effective treatment. Tricuspid valve replacement with biological prosthesis for intravenous drug abusers is associated with numerous early and late postoperative complications. Tricuspid valve reconstruction is a safe method of treatment in the early postoperative period. Key words: tricuspid valve, intravenous drug abusers, infective endocarditis, tricuspid valve reconstruction, tricuspid valve replacement, complications.

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Abrams, Dominic J. R., Philip Kilner, Janice A. Till, Darryl F. Shore, Babulal Sethia, Rodney C. G. Franklin, and Alan G. Magee. "Prolapse of the antero-superior leaflet of the tricuspid valve secondary to congenital anomalies of the valvar and sub-valvar apparatus: a rare cause of severe tricuspid regurgitation." Cardiology in the Young 15, no. 4 (July 13, 2005): 417–21. http://dx.doi.org/10.1017/s1047951105000867.

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Congenital anomalies of the tricuspid valve, and/or its supporting apparatus, leading to severe tricuspid regurgitation are rare. Although well tolerated in early childhood, long-standing and progressive volume loading of the right heart leads to symptoms of decreased exercise tolerance, and may predispose to arrhythmias in the long term. We report three cases of severe tricuspid regurgitation related to anomalies of the cords supporting the antero-superior leaflet of the tricuspid valve. Shortened cords leading to tethering of the leaflet were seen in two cases, and hypoplasia of the leaflet in the other. In all cases, the regurgitant jet was directed posteriorly towards the coronary sinus and atrial septum. Surgical repair was possible in one case, while it proved necessary to replace the valve in a second. The third child is asymptomatic and under regular review.

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Loyalka, Pranav, Angelo Nascimbene, Benjamin Metz, Igor D. Gregoric, Ajay Sundara Raman, and Biswajit Kar. "Transcatheter Tricuspid Valve-in-Valve Replacement with an Edwards Sapien 3 Valve." Texas Heart Institute Journal 44, no. 3 (June 1, 2017): 209–13. http://dx.doi.org/10.14503/thij-15-5639.

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A few case reports and case series have documented the outcomes in patients with tricuspid bioprosthetic valvular degeneration who underwent transcatheter implantation of the Medtronic Melody and the Edwards Sapien XT and Sapien 3 valves. In this report, we describe the case of a 49-year-old woman with severe bioprosthetic tricuspid valvular stenosis and multiple comorbidities who underwent transcatheter tricuspid valve replacement with a Sapien 3 valve.

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Miki, Takao, Satoshi Ohki, Tamiyuki Obayashi, Kiyomitsu Yasuhara, Shuichi Okonogi, and Tadashi Umeno. "Aortic and tricuspid valve infective endocarditis caused by Streptococcus suis." Asian Cardiovascular and Thoracic Annals 27, no. 9 (May 2, 2019): 751–53. http://dx.doi.org/10.1177/0218492319847381.

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Streptococcus suis is a zoonotic pathogen that causes invasive infections in humans. We report a case of aortic and tricuspid valve infective endocarditis caused by Streptococcus suis, which required cardiac surgery. The patient was a 53-year-old man with high fever and general fatigue for one month. He had been a pig farmer for 30 years. His blood cultures were positive for Streptococcus suis, and transthoracic echocardiography revealed aortic and tricuspid regurgitation with mobile vegetations adhering to the tricuspid valve. We performed aortic valve neo-cuspidization using autologous pericardium, and tricuspid valve replacement using a biological valve.

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Kobza, R., D. J. Kurz, E. N. Oechslin, R. Prêtre, M. Zuber, P. Vogt, and R. Jenni. "Aberrant tendinous chords with tethering of the tricuspid leaflets: a congenital anomaly causing severe tricuspid regurgitation." Heart 90, no. 3 (February 13, 2004): 319–23. http://dx.doi.org/10.1136/hrt.2002.006254.

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Abstract:

Objective: To define the entity of tricuspid regurgitation caused by tethering of the tricuspid valve leaflets by aberrant tendinous chords.Design: Retrospective study.Setting: Tertiary care centre (university teaching hospital).Patients: 10 patients with unexplained severe tricuspid regurgitation.Methods: The last 13 500 echocardiographic studies from our facility were reviewed to identify patients with severe unexplained tricuspid regurgitation. Tethering was defined by the presence of aberrant tendinous chords to the tricuspid valve leaflets limiting the mobility of the tricuspid leaflet and resulting in incomplete coaptation and apical displacement of the regurgitant jet origin. Aberrant tendinous chords were defined as those inserting at the clear zone of the tricuspid leaflet and not originating from the papillary muscle. Patients fulfilling the diagnostic criteria for Ebstein’s anomaly were excluded.Results: 10 patients with aberrant tendinous chords tethering one or more tricuspid valve leaflets were identified. There were short non-aberrant tendinous chords in seven patients, five of whom also had right ventricular or tricuspid annulus dilatation.Conclusions: Tethering of the tricuspid valve leaflets by aberrant tendinous chords can be the sole mechanism of congenital tricuspid regurgitation. It is often associated with short non-aberrant tendinous chords, which may develop secondary to right ventricular or tricuspid annulus dilatation. Awareness of tethering as a cause of tricuspid regurgitation may be important in planning reconstructive surgery.

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Journal articles on the topic 'Valva Tricuspide'

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