Functional tricuspid regurgitationBasis for Intervention on Functional Tricuspid Regurgitation
Section snippets
Correction of Annular Dilation as the Basis for Intervention on Functional Tricuspid Regurgitation
Contrary to the traditional view, correction of left-sided valvular disease does not automatically correct functional tricuspid regurgitation.15 Treatment of the mitral lesion alone only decreases the afterload. It does not correct tricuspid dilation, nor does it affect preload or RV function.16 Dilatation of the tricuspid annulus is progressive and may not be accompanied by tricuspid regurgitation initially, but eventually leads to it.16
The normal tricuspid valve annulus is a bimodal nonplanar
Tackling of Tethering as the Basis for Intervention to Prevent Residual or Recurrent Functional Tricuspid Regurgitation
Current treatment of functional tricuspid regurgitation consists of resizing the annulus with either ring or suture annuloplasty.20 Unfortunately, the success of tricuspid valve repair is often uncertain, especially with suture repair techniques, and results in residual, recurrent or progressive tricuspid regurgitation after tricuspid valve annnuloplasty.10, 11, 12, 13, 14 The presence of residual or recurrent tricuspid regurgitation is associated with increased perioperative and late
Conclusions
The management of functional tricuspid regurgitation remains a perplexing issue. However, in recent years better understanding of the pathophysiology of this complex entity has aided us in adopting a more proactive approach to deal with it. There is no question that patients with severe functional tricuspid regurgitation should have this corrected at the time of left-sided heart-valve surgery. For those with less than severe tricuspid regurgitation, the tricuspid annulus should be measured
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Application of a Series of Two-Dimensional Transesophageal Echocardiographic (2D TEE) Views Across Multiple Axes Improves the Accuracy of Tricuspid Annular Measurements
2021, Journal of Cardiothoracic and Vascular AnesthesiaOutcomes of Guideline-Directed Concomitant Annuloplasty for Functional Tricuspid Regurgitation
2020, Annals of Thoracic SurgeryImaging Assessment of Tricuspid Regurgitation Severity
2019, JACC: Cardiovascular ImagingAnatomy and Physiology of the Tricuspid Valve
2019, JACC: Cardiovascular ImagingTranscatheter Tricuspid Valve Interventions: Landscape, Challenges, and Future Directions
2018, Journal of the American College of CardiologyCitation Excerpt :In patients with lead-induced TR, coaptation devices may be prioritized, whereas TTVR could be considered for patients with intracardiac leads and extreme tricuspid annular dilation, as well as for rheumatic TR. Secondary TR has been divided into 3 stages for therapeutic purposes (76). In the early stage, initial dilation of the right ventricle leads to tricuspid annular dilation without significant leaflet tethering.
Severity of tricuspid regurgitation is associated with long-term mortality
2018, Journal of Thoracic and Cardiovascular Surgery