• 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.26 no.11
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• pp.827-832
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• 1993

From Jan 1982 through Dec.1991, thirty-three DeVega`s tricuspid annuloplasties were performed in association with mitral and combined mitral and aortic valve disease. Preoperatively,all of the patients were in NYHA functional class III or IV.There were one early death and 4 patients died during follow up period of 18 to 138 months [ mean follow up : 67.3 months ]. Nine patients required reoperation because of biological mitral valve failure at 4.7 to 11 years after tricuspid annuloplasty[TAP]. Among these patients,2 cases needed for reoperation of TAP due to loosening of suture material. Twenty four [86%] of the survivors were in NYHA functional class I or II after TAP.The actuarial survival rate for the TAP was 74% at 138 months. Rt atrial pressure of 9 reoperation cases were significantly decreased [P<0.05] compared with initial Rt.atrial pressure [ Mean period; 93.6 months].Doppler echocardiographic studies for tricuspid regurgitation were performed in 15 cases after TAP [Mean period: 42.3 months].These results showed significantly reduced [P<0.01] tricuspid annulus diameter and tricuspid regurgitation distance [ P<0.05 ].Our surgical experience that the DeVega`s TAP is a simple,safe,effective procedure and resulted in good hemodynamic improvement with moderate to severe functional tricuspid regurgitation.

• Korean Journal of Radiology
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• v.22 no.12
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• pp.1946-1963
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• 2021

Cardiac computed tomography (CT) and cardiac magnetic resonance imaging (CMR) can reveal the detailed anatomy and function of the tricuspid valve and right ventricle (RV). Quantification of tricuspid regurgitation (TR) and analysis of RV function have prognostic implications. With the recently available transcatheter treatment options for diseases of the tricuspid valve, evaluation of the tricuspid valve using CT and CMR has become important in terms of patient selection and procedural guidance. Moreover, CT enables post-procedural investigation of the causes of valve dysfunction, such as pannus or thrombus. This review describes the anatomy of the tricuspid valve and CT and CMR imaging protocols for right heart evaluation, including RV function and TR analyses. We also demonstrate the pre-procedural planning for transcatheter treatment of TR and imaging of postoperative complications using CT.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.325-331
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• 2020

Background: We evaluated the association between tricuspid annular dilatation and the development of moderate or severe tricuspid regurgitation (TR). Additionally, we determined the optimal tricuspid annular dilatation threshold to use as an indicator for tricuspid annuloplasty in patients with less-than-moderate functional TR (FTR). Methods: Between August 2007 and December 2014, 227 patients with less-than-moderate TR underwent mitral valve surgery without a tricuspid valve (TV) procedure. The TV annular diameter was measured via transthoracic echocardiography. The TV annular index (TVAI) was calculated as the TV annular diameter divided by the body surface area. The mean duration of echocardiographic follow-up was 42.0 months (interquartile range, 9.3-66.6 months). Results: Eight patients (3.5%) developed moderate or severe TR. The rate of freedom from development of moderate or severe TR at 5 years was 96.2%. TV annular diameter, left atrial diameter, preoperative atrial fibrillation, and TVAI were found to be associated with the development of moderate or severe TR in the univariate analysis. A cut-off TVAI value of 19.8 mm/㎡ was found to predict the development of moderate or severe TR, and a significant difference was observed in the development of TR of this severity based on this cut-off (p<0.001). Conclusion: The progression of TR was not infrequent in patients with untreated lessthan-moderate FTR. An aggressive treatment approach can be helpful to prevent the progression of FTR for patients with risk factors, especially TVAI greater than 19.8 mm/㎡.

• 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.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.24 no.9
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• pp.907-912
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• 1991

Isolated primary tricuspid insufficiency except Ebstein`s anomaly is rare disease. Recently we experienced two cases of isolated primary tricuspid insufficiency and treated successfully with annuloplasty or valve replacement. We could not classify our case as one of the classification of isolated tricuspid insufficiency, because the morphology and microscopic finding did not suggest any similar variety.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.672-676
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• 1989

We experienced a case of congenital tricuspid stenosis. The patient was 5 years old boy. The 2D-echo 4 cardiac catheterization with cineangiogram revealed as Tricuspid Stenosis, associated with functioning patent foramen ovale & mild R.V hypoplasia. The lesion was successfully corrected by TV commissurotomy & closure of PFO. Postoperatively, moderate degree of tricuspid regurgitation was remained.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.88-90
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• 2005

Tricuspid annuloplasty with the flexible Duran ring may result in a physiologic repair while maintaining the dynamic morphology of the tricuspid annulus. A method for a durable three-dimensional tricuspid annular reconstruction, which retains the plasticity and orifice area of the tricuspid annulus, is described.

• 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.