Document Detail

The importance of tricuspid valve structure and function in the surgical treatment of rheumatic mitral and aortic disease.
MedLine Citation:
PMID:  1597224     Owner:  NLM     Status:  MEDLINE    
A significant proportion of individuals with rheumatic disease have tricuspid valve involvement which may be clinically important and alter the medical or surgical approach to treatment. Therefore 50 patients with rheumatic left-sided valvular lesions who were referred for operative treatment were studied. Thirty patients had angiographically significant tricuspid regurgitation (group I) and 20 had a competent tricuspid valve (group II). Pre-operative cardiac assessment included Doppler echocardiography and contrast ventriculography. Patients with tricuspid regurgitation more commonly had mitral valve disease or combined mitral and aortic valve lesions, (P less than 0.001) and were more likely to have atrial fibrillation than those without tricuspid regurgitation (P less than 0.001). Pulmonary arterial systolic and mean right atrial pressures were higher in group I (both P less than 0.01). A close relationship was found between the angiographic and Doppler assessment of the degree of tricuspid regurgitation (P less than 0.01). Doppler-derived measurement of the right ventricular-right atrial systolic pressure difference correlated well with the systolic trans-tricuspid pressure difference measured at cardiac catheterization (y = 0.7x + 22, r = 0.67, P less than 0.001) and the pulmonary arterial systolic pressure (y = 0.8x + 27, r = 0.71, P less than 0.001). Rheumatic involvement of the tricuspid valve identified by pre-operative echocardiography was confirmed in five patients at surgery. Of the 13 patients with functional tricuspid regurgitation at operation, only two had been diagnosed as having organic disease by echocardiography. Furthermore, in all 18 cases where Doppler suggested grade 3 or 4+ tricuspid regurgitation, surgical repair or replacement of the valve was performed.(ABSTRACT TRUNCATED AT 250 WORDS)
L Farid; M K Dayem; R Guindy; R Shabetai; H C Dittrich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  13     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-07-07     Completed Date:  1992-07-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  366-72     Citation Subset:  IM    
Division of Cardiology, University of California, San Diego.
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MeSH Terms
Aortic Valve / radiography,  surgery*,  ultrasonography
Heart Valve Diseases / surgery,  ultrasonography
Mitral Valve / surgery*,  ultrasonography
Radionuclide Ventriculography
Rheumatic Heart Disease / radionuclide imaging,  surgery*,  ultrasonography
Tricuspid Valve / physiopathology,  radionuclide imaging,  ultrasonography
Tricuspid Valve Insufficiency / physiopathology,  radionuclide imaging,  ultrasonography*
Ventricular Function, Right*

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

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