Document Detail


Tricuspid regurgitation after cardiac transplantation: an old problem revisited.
MedLine Citation:
PMID:  18342744     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Tricuspid regurgitation (TR) is the most common valvular abnormality after orthotopic heart transplantation (OHT), with a reported incidence of up to 84%, depending on the definition of significant regurgitation and surgical methods of OHT employed. While multiple etiologies are implicated in the development of TR after OHT, endomyocardial biopsy (EMB), performed to detect allograft rejection, is the single most important contributor to significant TR by causing anatomic disruption of the tricuspid valvular structure. Although the clinical course of TR is heterogeneous, hemodynamically significant regurgitation generally leads to progressive right-heart dysfunction and symptoms. In cases refractory to diuretic-based medical therapy, surgical correction of TR has been shown to effectively alleviate the condition and provide symptomatic and organ function improvement. Tricuspid valve repair and replacement are viable surgical options, the application of which often depends on the institution's experience and underlying valve pathology. A non-invasive surveillance technique to detect allograft rejection is on the horizon, and may reduce the number of EMBs performed as well as the procedure-related tissue damage that leads to TR.
Authors:
Raymond Ching-Chiew Wong; Zuheir Abrahams; Mazen Hanna; Joseph Pangrace; Gozalo Gonzalez-Stawinski; Randall Starling; David Taylor
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  27     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-17     Completed Date:  2008-04-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  247-52     Citation Subset:  IM    
Affiliation:
Section of Heart Failure Transplantation, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. hannam@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Biopsy
Disease Progression
Graft Rejection / diagnosis,  pathology
Heart Transplantation / adverse effects*
Humans
Myocardium / pathology
Tricuspid Valve / physiopathology,  surgery
Tricuspid Valve Insufficiency / etiology*,  physiopathology*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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