• Journal of Trauma and Injury
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• 제34권2호
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• pp.136-140
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• 2021

We present a case of delayed diagnosis of traumatic tricuspid valve rupture in a patient who was emergently brought to the operating room for repair of lacerations to the heart and liver without intraoperative transesophageal echocardiography (TEE). Initial postoperative transthoracic echocardiography (TTE) did not show structural pathology. One week later, TTE with better image quality showed severe tricuspid regurgitation. Subsequently, TEE clearly demonstrated rupture of the anterior papillary muscle and flail anterior tricuspid leaflet. The case description is followed by a brief discussion of the utility of TEE in the setting of blunt thoracic trauma.

• Journal of Chest Surgery
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• 제56권5호
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• pp.304-310
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• 2023

Background: The late progression of tricuspid regurgitation (TR) after mitral valve surgery is well known. However, few reports have described the progression of TR after aortic valve surgery. We investigated the incidence of and risk factors for the development of significant TR after isolated aortic valve replacement (AVR). Methods: This study analyzed patients with less than moderate TR who underwent isolated AVR at Seoul National University Hospital from January 1990 to December 2018. Significant TR was defined as moderate or higher. Echocardiographic follow-up was performed in all patients. The Fine-Gray model was used to identify clinical risk factors for the development of significant TR. Results: In total, 583 patients (61.7±14.2 years old) were included. Operative mortality occurred in 9 patients (1.5%), and the overall survival rates at 10, 20, and 25 years were 91.1%, 83.2%, and 78.9%, respectively. Sixteen patients (2.7%) developed significant TR during the follow-up period (13 moderate; 3 severe). The cumulative incidence of significant TR at 10, 20, and 25 years was 0.77%, 3.83%, and 6.42%, respectively. No patients underwent reoperation or reintervention of the tricuspid valve. Hemodialysis or peritoneal dialysis for chronic kidney disease (hazard ratio [HR], 5.188; 95% confidence interval [CI], 1.154-23.322) and preoperative mild TR (HR, 5.919; 95% CI, 2.059-17.017) were associated with the development of significant TR in the multivariable analysis. Conclusion: TR progression after isolated AVR in patients with less than moderate TR is rare. Preoperative mild TR and hemodialysis or peritoneal dialysis for chronic kidney disease were significant risk factors for the development of TR.

• Journal of Chest Surgery
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• 제46권1호
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• pp.60-62
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• 2013

Quadrangular resection is the gold standard technique for correction of the posterior leaflet prolapse in mitral valve disease. Prompted by the idea that the anterior leaflet of the tricuspid valve corresponds to the posterior leaflet of the mitral valve in its structure and function, we conducted a quadrangular resection of the anterior leaflet of the tricuspid valve in a case of tricuspid endocarditis. Tricuspid regurgitation was well corrected, and the durability of the repair was proven by the patient's freedom from cardiac events for the following 8 years.

• Journal of Chest Surgery
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• 제27권3호
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• pp.234-237
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• 1994

We report a case of double orifice mitral valve complicating a partial atrioventricular septal defect.The preoperative diagnosis was suggested by a characteristic angiographic and echocardiographic findings but the correct diagnosis of double orifice mitral valve itself was proven by open heart surgery. The smaller accessory mitral orifice was located in the left lateral leaflet and was left untouched. The A-V septal defect was closed with Gore-Tex patch and localized tricuspid annuloplasty was done using Gore-Tex tubular graft for correction of severe tricuspid regurgitation. The anterior mitral cleft left intact had mild mitral regurgitation on postoperative echocardiography.Postoperative course was uneventful and the patient was discharged 2 weeks later.

• Journal of Chest Surgery
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• 제56권1호
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• pp.56-58
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• 2023

Untreated severe tricuspid regurgitation (TR) is associated with poor outcomes. Functional TR occurs secondary to dilatation of the annulus and tethering of the leaflets. Ring annuloplasty alone can correct most cases, but is insufficient in cases of severe annular dilatation due to severe leaflet tethering. In such cases, a tricuspid edge-to-edge technique may be an option. However, stitching of the leaflet tips alone is likely to result in tearing of the leaflets. Approximation of the durable chordae tendineae is considered helpful for this problem. Herein, we present the case of a 39-year-old man who had undergone open-heart surgery for acute type A aortic dissection 13 months earlier. A right mini-thoracotomy approach with a beating-heart strategy was used, which did not require unnecessary pericardial adhesiolysis and dissection. This technique had the advantage of reducing the operation time and the risk of bleeding. To summarize, we present a case of tricuspid valve repair in a high-risk patient with severe leaflet tethering that was successfully managed using these methods.

• Journal of Chest Surgery
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• 제29권5호
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• pp.559-563
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• 1996

We have experienced a patient, 16 year-old male, with ventricular septal defect with tricuspid recur- gitation due to blunt chest trauma. He suffered from congestive heart failure after the trauma. Echocardiogram and cardiac catheterization revealed left to right shunt at the ventricular level (muscu- far portion of interventricular septum) and tricuspid regurgitation. At the time of the operation, marked systolic thrill was palpable over the rlght ventricle near the apex and a chorda tendina was seen sharply ruptured just near the medial papillary muscle. We repaired the ventricular septal defect with a Dacron patch and chordal reconstruction with autologous pericardium. The postoperative course was uneventful and the patient was discharged in good condition.

• 한국임상수의학회지
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• 제35권6호
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• pp.269-272
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• 2018

A 4-year-old, 6.1 kg intact female dachshund was referred to the Animal Medical Center with acute right hind limb lameness. Radiographs revealed fractures of iliac body and tibia in the right limb. In addition, the dog exhibited tricuspid valve regurgitation and moderate heartworm infection in the right ventricle and main pulmonary artery on echocardiogram. To obtain stable anesthetic conditions for operation, an adult heartworm removal procedure was previously followed by repair of the complex fractures. All surgical procedures were done without complication and with stable patient conditions. At a one month postoperative follow-up, the dog was doing well with normal ambulation and no tricuspid valve regurgitation as well.

• 한국임상수의학회지
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• 제36권6호
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• pp.336-339
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• 2019

A castrated, 6-year-old, male Turkish Angora cat with a history of respiratory distress was referred to the hospital. Physical examination revealed a cardiac murmur, and thoracic radiographic findings revealed pleural effusion and cardiomegaly. Echocardiography showed abnormality of the tricuspid and mitral valve, and color-flow Doppler imaging revealed regurgitation between both atrium and ventricle. Based on the echocardiographic examination, tricuspid valve dysplasia concurrent with mitral valve dysplasia was diagnosed. However, the patient died a week after treatment. In necropsy, bilateral atrioventricular valve dysplasia and left ventricular hypertrophy were confirmed. This is the first report to describe a middle age Turkish angora cat having bilateral atrioventricular valve dysplasia which has high mortality and only been reported rarely in cats. This case report also describes its clinical signs, diagnostic imaging findings, treatment and discussions how the patient could live long.

• Journal of Chest Surgery
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• 제56권5호
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• pp.311-312
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• 2023

• 한국임상수의학회지
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• 제32권1호
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• pp.101-104
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• 2015

4년령의 수컷 골든 리트리버 견이 복부 팽만 및 호흡곤란을 주증상으로 내원하였으며, 신체 검사 결과 부정맥과 심잡음이 청진되었다. 흉복부 방사선 검사 결과 전반적인 심비대, 흉수 및 복수가 관찰되었다. 심초음파 검사에서 비정상적인 승모판 및 삼첨판의 움직임과 역류가 관찰되었으며, 좌심실의 편심성 비대와 좌심방 비대가 보였다. 컬러 도플러 영상에서 확장기에 승모판 입구로부터 좌심실로 유입되는 와류가 관찰되었으며, 수축기에는 좌심방 및 우심방으로의 와류가 보였다. 도플러 검사로 확장기 승모판 유입 속도가 매우 증가하였으며 pressure half time이 지연되었다는 것을 알 수 있었다. 심초음파 검사 결과에 기초하여 승모판 협착증과 병발된 승모판 이형성증과 삼첨판 이형성증을 진단하였다.