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isolated tricuspid regurgitation

Philipp E Bartko, Henrike Arfsten, Gregor Heitzinger, Noemi Pavo, Max-Paul Winter, Aurel Toma, Guido Strunk, Christian Hengstenberg, Martin Hülsmann, Georg Goliasch
Aims: Bivalvular functional regurgitation (BVFR) defined as concomitant mitral and tricuspid insufficiency has not been described or systematically assessed before. Therefore, this study sought to define incidence, impact and natural history of BVFR in heart failure with reduced ejection fraction (HFrEF) to provide the foundation for risk assessment and directions for potential treatment strategies. Methods and results: We enrolled 1021 consecutive patients with HFrEF under guideline-directed medical therapy and performed comprehensive echocardiographic and neurohumoral profiling...
December 1, 2018: European Heart Journal Cardiovascular Imaging
Naoto Fukunaga, Tadaaki Koyama
PURPOSE: Isolated tricuspid valve surgery (TVS) following valvular surgery has been still challenging. We reviewed our experience to determine early and late outcomes. METHODS: We retrospectively analyzed 14 patients (mean age, 57.0 ± 17.8 years old) who underwent isolated TVS after valvular surgery between January 1990 and December 2010. The causes of isolated TVS were structural valve deterioration (SVD) (n = 5) and symptomatic severe tricuspid regurgitation (n = 9)...
November 28, 2018: Annals of Thoracic and Cardiovascular Surgery
Min Soo Cho, Jun Kim, Jung-Bok Lee, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim
INTRODUCTION: The incidence and predictors of tricuspid regurgitation (TR) after permanent pacemaker (PM) implantations have not been well evaluated. We attempted to determine TR's natural course and predictors, especially focusing on the influence of atrial fibrillation (AF). METHODS: Data from 530 patients with dual-chamber PMs were evaluated. The main study outcomes were moderate to severe TR and isolated TR (moderate to severe TR without other structural heart diseases [SHDs]) in follow-up echocardiography...
November 11, 2018: Pacing and Clinical Electrophysiology: PACE
Yoshiya Kato, Arata Fukushima, Hiroyuki Iwano, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Severe tricuspid regurgitation (TR) is reported to represent a hemodynamic pattern similar to that of constrictive pericarditis (CP), which should be clearly differentiated for appropriate management. We report the case of a patient with severe TR due to atrial fibrillation (AF) in whom hemodynamic monitoring played a role in the selection of the management strategy. An 81-year-old Japanese man with chronic AF was admitted due to worsening heart failure. Echocardiography showed the dilation of bilateral atria and a right ventricle with severe TR...
November 2018: Journal of Cardiology Cases
Zhi Hao Teoh, James Roy, Joseph Reiken, Michael Papitsas, Jonathan Byrne, Mark Monaghan
Moderate-to-severe tricuspid regurgitation is associated with higher mortality and morbidity yet remains significantly undertreated. The reasons for this are complex but include a higher operative mortality for patients undergoing isolated tricuspid valve surgery. This study sought to determine the prevalence of patients with moderate-to-severe tricuspid regurgitation and identify those who could be potentially suitable for percutaneous tricuspid valve intervention by screening patients referred for transthoracic echocardiography (ECHO) at a tertiary center...
October 1, 2018: Echo Research and Practice
Patricia Corzo, Anna Pros, Juana Martinez-Llorens, Luis Molina, Stephanie Fenxi Ling, Eva Balcells
INTRODUCTION: Diffusing capacity for carbon monoxide (DLco) reduction is the first detectable pulmonary functional test (PFT) change in systemic sclerosis (SSc)-related pulmonary complications. reduction in patients without cardiopulmonary alterations has also been observed; a good characterisation of these patients is lacking. The objective of this study is to describe the characteristics of SSc patients with isolated DLco reduction and compare these patients to SSc patients with DLco reduction with a known cause...
December 2018: Clinical Rheumatology
Krishna Kumar Mohanan Nair, Sanjay Ganapathi, Sonali Inamdar, Arun Gopalakrishnan, Tirur Raman Kapilamoorthy, Ajitkumar Valaparambil
An isolated right-sided aortic arch with no congenital heart disease is extremely rare. We report an adult woman with longstanding rheumatic heart disease causing severe calcific mitral stenosis, moderate mitral regurgitation and moderate pulmonary hypertension, for which she underwent mitral valve replacement and tricuspid annuloplasty. On preoperative work-up, she was detected to have a right-sided aortic arch with mirror image branching along with a ductal dimple. However, there were no associated congenital cardiac defects...
January 2018: National Medical Journal of India
Martijn G Slieker, James M Meza, Paul J Devlin, Phillip T Burch, Tara Karamlou, William M DeCampli, Brian W McCrindle, William G Williams, Conall T Morgan, Craig E Fleishman, Luc Mertens
Aims: The aims of this study were to provide a detailed descriptive analysis of pre-intervention morphologic and functional echocardiographic parameters in a large, unselected, multicentre cohort of neonates diagnosed with critical left heart obstruction and to compare echocardiographic features between the different subtypes of left-sided lesions. Methods and results: Pre-intervention echocardiograms for 651 patients from 19 Congenital Heart Surgeons' Society (CHSS) institutions were reviewed in a core lab according to a standardized protocol including >150 morphologic and functional variables...
October 17, 2018: European Heart Journal Cardiovascular Imaging
Younes Moutakiallah, Mahdi Aithoussa, Noureddine Atmani, Aniss Seghrouchni, Azeddine Moujahid, Abdedaïm Hatim, Iliyasse Asfalou, Zouhair Lakhal, Abdelatif Boulahya
BACKGROUND: The reoperation for isolated tricuspid regurgitation in rheumatic population is rare and still unclear and controversial because of the rarity of publications. The aim of this study was to analyze short and long-term results and outcome of tricuspid valve surgery after left-sided valve surgery in rheumatic patients. METHODS: Twenty six consecutive rheumatic patients who underwent isolated tricuspid valve surgery after left-sided valve surgery between January 2000 and January2017 were retrospectively registered in the study...
October 4, 2018: Journal of Cardiothoracic Surgery
Lluis Asmarats, François Dagenais, Elisabeth Bédard, Sergio Pasian, Rebecca T Hahn, José L Navia, Josep Rodés-Cabau
Despite the growing evidence with emerging transcatheter tricuspid valve repair therapies, the experience with transcatheter tricuspid valve replacement remains sparse. We describe a case of severe tricuspid regurgitation in a 79-year-old patient deemed unsuitable for isolated tricuspid valve surgery, successfully treated with a 40-mm self-expandable NaviGate (NaviGate Cardiac Structures, Inc, Lake Forest, CA) valved stent via a transatrial approach, with excellent result and hemodynamic performance at 4 months...
October 2018: Canadian Journal of Cardiology
Mohamad Alkhouli, Chalak Berzingi, Amer Kowatli, Fahad Alqahtani, Vinay Badhwar
Background: Comparative outcome data on tricuspid valve repair (TVr) versus tricuspid valve replacement (TVR) for severe secondary tricuspid regurgitation (TR) are limited. Methods: We used a national inpatient sample to assess in-hospital morbidity and mortality, length of stay and cost in patients with severe secondary TR undergoing isolated TVr versus TVR. Results: A total of 1364 patients (national estimate=6757) underwent isolated tricuspid valve surgery during the study period, of whom 569 (41...
2018: Open Heart
Yan Topilsky, Simon Maltais, Jose Medina Inojosa, Didem Oguz, Hector Michelena, Joseph Maalouf, Douglas W Mahoney, Maurice Enriquez-Sarano
OBJECTIVES: This study sought to analyze patients with tricuspid regurgitation (TR) diagnosed in the community setting (Olmsted County) by Doppler echocardiography to define the prevalence, characteristics, and implications of clinically significant (greater or equal to moderate) TR. BACKGROUND: The prevalence, cause distribution, and significance of TR are mostly unknown. METHODS: All adult residents of Olmsted County, Minnesota, who underwent clinically indicated Doppler echocardiography between 1990 and 2000 were evaluated for presence of greater or equal to moderate TR...
August 6, 2018: JACC. Cardiovascular Imaging
Takao Konishi, Hironori Murakami, Shinya Tanaka
CLINICAL INTRODUCTION: A 59-year-old woman visited an outpatient cardiology clinic due to shortness of breath on exertion. Physical examination showed no significant abnormality of vital signs. A III/VI systolic murmur was heard on the fourth intercostal space at the right sternal border. The majority of laboratory tests were normal. Chest X-ray showed a curved vessel shadow (figure 1A). Initial transthoracic echocardiography showed abnormal blood flow into the inferior vena cava (IVC) in the subxiphoid long axis view (figure 1B) and mild right heart dilatation (online supplementary figure 1)...
August 9, 2018: Heart: Official Journal of the British Cardiac Society
Sajad Shehab, Sabine M Allida, Phillip J Newton, Desiree Robson, Peter S Macdonald, Patricia M Davidson, Paul C Jansz, Christopher S Hayward
Aortic regurgitation (AR), mitral regurgitation (MR), and tricuspid regurgitation (TR) after continuous-flow left ventricular assist device (LVAD) are common and may increase with prolonged LVAD support. The aim of this study was to simulate severe valvular regurgitation (AR, MR, and TR) within a 4-elemental pulsatile mock circulatory loop (MCL) and observe their impact on isolated LVAD and biventricular assist device (BiVAD) with HeartWare HVAD. Aortic regurgitation, MR, and TR were achieved via the removal of one leaflet from bileaflet mechanical valve from the appropriate valves of the left or right ventricles...
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jose L Navia, Samir Kapadia, Haytham Elgharably, Gabriel Maluenda, Krzysztof Bartuś, Cristian Baeza, Rajesh K Nair, Josep Rodés-Cabau, Cesare Beghi, Rodolfo C Quijano
Patients with isolated functional or recurrent tricuspid regurgitation are often denied surgery because they are considered to be at high risk. Transcatheter valve therapy provides a less invasive alternative for tricuspid regurgitation associated with right heart failure. We have evaluated the feasibility of transcatheter tricuspid valve implantation of the NaviGate valved stent in a long-term swine model. The valved stent was successfully implanted through transjugular and transatrial approaches on the beating heart with excellent hemodynamic and valve performance...
February 2018: JACC. Basic to Translational Science
Yasunori Iida, Susumu Fujii, Sho Akiyama, Shigeharu Sawa
OBJECTIVES: This study aimed to elucidate the surgical outcome of aortic valve neocuspidization (AVNeo) in patients with aortic stenosis (AS). METHODS: From December 2010 to June 2017, we performed AVNeo for aortic valve pathologies in 144 patients. Of them, we evaluated 57 patients with AS who underwent AVNeo. Their mean age was 77.5 ± 8.8 years. Fifty-five patients had AS from degenerative changes, 1 from pericardium endocarditis, and 1 from prosthetic valve endocarditis...
November 2018: General Thoracic and Cardiovascular Surgery
James S Gammie, Joanna Chikwe, Vinay Badhwar, Dylan P Thibault, Sreekanth Vemulapalli, Vinod H Thourani, Marc Gillinov, David H Adams, J Scott Rankin, Mehrdad Ghoreishi, Alice Wang, Gorav Ailawadi, Jeffrey P Jacobs, Rakesh M Suri, Steven F Bolling, Nathaniel W Foster, Rachael W Quinn
BACKGROUND: Data from The Society of Thoracic Surgeons Adult Cardiac Surgery Database were analyzed to identify trends in patient characteristics and outcomes of mitral valve operations in North America. METHODS: All patients with isolated primary mitral valve operations with or without tricuspid valve repair, surgical atrial fibrillation ablation, or atrial septal defect closure performed July 2011 to September 2016 were identified. A subgroup analysis assessed patients with degenerative leaflet prolapse (DLP)...
September 2018: Annals of Thoracic Surgery
Sajad Shehab, Sriram Rao, Peter Macdonald, Phillip J Newton, Phillip Spratt, Paul Jansz, Christopher S Hayward
OBJECTIVES: We report our experience with temporary postoperative venopulmonary arterial extracorporeal life support as short-term right ventricular support in patients with biventricular failure undergoing HeartWare (HeartWare Inc, Framingham, Mass) left ventricular assist device implantation and compared these outcomes with isolated left ventricular assist device support and long-term biventricular assist device support. METHODS: A total of 112 consecutive patients were studied, 75 with the isolated HeartWare left ventricular assist device, 23 with a concomitant left ventricular assist device and venopulmonary arterial extracorporeal life support, and 14 with durable biventricular assist device support...
June 5, 2018: Journal of Thoracic and Cardiovascular Surgery
Damiano Regazzoli, Antonio Mangieri, Ozan Demir, Marco B Ancona, Giuseppe Lanzillo, Francesco Giannini, Pier P Leone, Antonio Colombo, Azeem Latib
Tricuspid valve regurgitation has a high prevalence and, when severe, is associated with poor outcomes. Nevertheless, surgical repair or replacement (isolated or as a part of a combined procedure) is rarely performed due to high surgical risk. Therefore, there is a significant unmet clinical need for percutaneous transcatheter-based treatments. Significant development in percutaneous therapies for both aortic and mitral valve disease has been accomplished over the last two decades, while transcatheter therapies for the tricuspid valve are still at an early stage...
June 29, 2018: Minerva Cardioangiologica
Christian Besler, Stephan Blazek, Karl-Philipp Rommel, Thilo Noack, Maximilian von Roeder, Christian Luecke, Joerg Seeburger, Joerg Ender, Michael A Borger, Axel Linke, Matthias Gutberlet, Holger Thiele, Philipp Lurz
OBJECTIVES: The present study aimed to test the clinical benefit of combined transcatheter mitral plus tricuspid valve edge-to-edge repair (TMTVR) as compared with transcatheter mitral valve edge-to-edge repair (TMVR) alone in patients with both significant mitral (MR) and tricuspid regurgitation (TR) at high surgical risk. BACKGROUND: A growing number of patients with severe MR at increased surgical risk are treated by transcatheter techniques. Evidence suggests that residual TR remains a predictor of adverse outcome in these patients...
June 25, 2018: JACC. Cardiovascular Interventions
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