• Journal of Chest Surgery
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• v.48 no.2
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• pp.129-133
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• 2015

Severe and permanent tricuspid regurgitation induced by pacemaker leads is rarely reported in the literature. The mechanism of pacemaker-induced tricuspid regurgitation has been identified, but its management has not been well established. Furthermore, debate still exists regarding the proper surgical approach. We present the case of a patient with severe tricuspid regurgitation induced by a pacemaker lead, accompanied by triple valve disease. The patient underwent double valve replacement and tricuspid valve repair without removal of the pre-existing pacemaker lead. The operation was successful and the surgical procedure is discussed in detail.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.1049-1051
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• 1999

We performed a reoperation of failed tricuspid mechanical valve in a 63-year-old female patient because the overgrown endothelial pannus had entrapped the prosthetic leaflets. Four years ago, the patient underwent mitral and tricuspid valve replacements with 31 and 33 mm Carbomedics, respectively. The patient showed symptoms of neck vein distention, abdominal distention and peripheral edema. The chest film, echocardiography and cineangiography confirmed the diagnosis of tricuspid valve. During the operation, we found the entrapped leaflets of the tricuspid valve in a partially closed state and the endothelial pannus had overgrown into the leaflets. Carpentier-Edward bovine pericardial valve was inserted and the patient was discharged with no significant events.

• Korean Journal of Veterinary Research
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• v.48 no.4
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• pp.481-487
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• 2008

A 17-month-old intact male Cocker Spaniel was presented with primary complaints of severe ascites, exercise intolerance, and diarrhea. Diagnostic studies revealed tricuspid and pulmonic regurgitation on phonocardiogram, right ventricular enlargement on the electrocardiogram, typical right cardiac enlargement signs on the thoracic radiography and tricuspid valve malformation and marked enlargement of the right atrium and right ventricle on the echocardiography and tricuspid and pulmonary regurgitation on the color spectral echocardiography, suggesting tricuspid valve dysplasia and pulmonary hypertension. Using angiography and cardiac catheterization, pulmonary hypertension was ruled out. Further echocardiographic study revealed membranous valvular structures cranial to pulmonary annulus causing pulmonary regurgitation. Based on these findings on the diagnostic investigation, the case was diagnosed as tricuspid valve dysplasia complicated with pulmonic regurgitation. The dog was medically managed with furosemide, enalapril, nitroglycerine transdermal patch and pimobendan after the ascitic fluid removal.

• Journal of Chest Surgery
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• v.49 no.1
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• pp.35-38
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• 2016

The management of recurrent tricuspid regurgitation after tricuspid valve repair in patients with Ebstein anomaly is difficult, and tricuspid valve replacement is most commonly performed in such patients. We report two cases of recurrent tricuspid regurgitation in patients with Ebstein anomaly that were successfully re-repaired using the cone technique. The cone repair technique is a useful surgical method for reconstructing a competent tricuspid valve, and can be applied in patients who have undergone previous tricuspid valve repair.

• Journal of Chest Surgery
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• v.11 no.2
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• pp.185-193
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• 1978

Between April 1976 and March 1978, six cases of tricuspid valve replacement were done in the Department of Thoracic Surgery, Seoul National University Hospital. There were 4 men and 2 women and the age of the patients ranged from 17 years of the youngest to 48 years of the oldest. Most of them had characteristic symptoms of tricuspid valve disease, such as a systolic murmur audible over the lower sternum and varying with respiration, pulsatile and distended neck vein, and an enlarged and pulsatile liver. Preoperative functional levels according to NYHA Calcification were class III in 4 cases, and class IV in 2 eases. Most of the cases showed moderate to severe cardiomegaly in chest films and elevated right atrial pressure on preoperative right heart catheterization. Five of them underwent concomittent mitral valve replacement and one pulmonary valvotomy. All of them showed tricuspid insufficiency resulted from massive dilatation of annulus, destructive lesions of valve structure, or both anomalies. One postoperative hospital death was encountered and the cause of death was low out-put syndrome. All survivors showed clinical improvement and cardiomegaly regressed and left hospital in a good condition . *Attendum; Recently 2 more cases of tricuspid valve replacement with mitral valve replacement were done after this review.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.55-58
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• 1998

Surgical treatment is recommended in tricuspid valve endocarditis not responding to antibiotics or presenting severe heart failure. However, risk of early prosthetic valve endocarditis especially in drug addictors is principal concern in the treatment. A 37 year-old man with tricuspid valve endocarditis underwent staged operation of primary tricuspid valvulectomy and secondary bioprosthetic valve implantation successfully. We report it with references of literature.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.323-330
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• 1991

Residual significant tricuspid regurgitation after mitral valve operation may significantly increase postoperative morbidity and mortality. However, routine techniques to detect tricuspid regurgitation preoperatively and postoperatively are not accurate. Doppler echocardiography was performed preoperatively and postoperatively to assess its ability to evaluate and quantify the severity of tricuspid regurgitation. In 34 patients with tricuspid regurgitation secondary to mitral valvular disease the tricuspid regurgitations were semiquantified on a scale of 1 to 3+. The 34 patients were divided into two groups on the basis of severity of tricuspid regurgitation as assessed by preoperative Doppler echocardiography. Group I [8 patients] had mild[1+] regurgitation, and group II [26 patients] had moderate to severe[2 ~ 3%] tricuspid regurgitation. In all studied patients, preoperative Doppler echocardiographic studies for the degree of tricuspid regurgitation were correlated with clinical symptoms[including NYHA class] and hemodynamics[JVP and right ventricular systolic pressure], and used as the indicator to determine whether tricuspid annuloplasty should be performed or not. Patients with significant tricuspid regurgitation[group II ] had greater preoperative right ventricular systolic pressures and NYHA classes, although there was no correlation between them. The 8 patients with mild[1+] tricuspid regurgitation[group I ] didn`t undergo any procedure for the tricuspid regurgitation and their postoperative Doppler echocardiographic studies showed the less than mild[0 ~ 1+] tricuspid regurgitation, and the 26 patients with significant[>2+] tricuspid regurgitation, and the 26 patients with significant[>2+] tricuspid regurgitation[group II ] underwent tricuspid annuloplasty for the tricuspid regurgitation and the postoperative Doppler echocardiographic studies showed the findings similar to group I except 1 patient who underwent Carpentier`s ring annuloplasty and had severe right ventricular failure. Therefore, preoperative Doppler echocardiography can accurately assess the relative severity of tricuspid regurgitation. Importantly, postoperative Doppler echocardiography could conveniently determine the effect of tricuspid annuloplasty for the patients with significant tricuspid regurgitation. Doppler echocardiography may be an important diagnostic method both for evaluating the degree of residual tricuspid regurgitation after left heart operation as well as for determining which patients should undergo tricuspid valve repair.

• Journal of Chest Surgery
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• v.13 no.3
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• pp.229-232
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• 1980

Approximately 5 percent of infective endocarditis are limited to the right side of the heart, the tricuspid valve being the usual site of involvement. Usually there is no underlying cardiac disease, and the vegetations occur on previously normal tricuspid leaflets. This paper reports a case of bacterial endocarditis involving the bio-tricuspid valve in a patient with tetralogy of Fallot, and who required prosthetic valve replacement in addition to surgical therapy for the congenital lesions.

• Journal of Veterinary Clinics
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• v.19 no.2
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• pp.264-267
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• 2002

Tricuspid valve dysplasia was diagnosed in 2 month-old german shepherd dog. Radiographic and echocardiographic examination was performed and they revealed severe dilatation of the right atrium, dilatation of the right ventricle, and septal leaflet tethered to the right side of the septum. On Doppler echocardiography, tricuspid valve incompetence was detected, flow velocity ranging from 3-4 m/sec. Color Doppler examination showed large turbulent jet in the right atrium.

• Journal of Chest Surgery
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• v.44 no.3
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• pp.240-242
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• 2011

We experienced a case of ruptured aneurysm of the sinus of Valsalva, and this resulted in simultaneous aortic and tricuspid valve endocarditis through a shunt. The echocardiography showed a ruptured sinus of Valsalva aneurysm to the right atrium with a shunt. The aortic non-coronary cusp was fibro-thickened with vegetation. Vegetations of the septal leaflet and the anterior leaflet of the tricuspid valve were also found. The blood culture grew Enterococcus garllinarum. We replaced both tricuspid and aortic valve with successful surgical result.