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isolated tricuspid regurgitation

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...
July 25, 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)...
July 13, 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
Lluis Asmarats, Rishi Puri, Azeem Latib, José L Navia, Josep Rodés-Cabau
Tricuspid regurgitation is a common finding in patients with left-sided valvular or myocardial disease, often being a marker for late-stage chronic heart failure with a grim prognosis. However, isolated tricuspid valve surgery remains infrequent and is associated with the highest mortality among all valve procedures. Hence, a largely unmet clinical need exists for less invasive therapeutic options in these patients. In recent times, multiple percutaneous therapies have been developed for treating severe tricuspid regurgitation, including tricuspid valve repair and, more recently replacement, opening an entirely new venue for managing tricuspid regurgitation...
June 26, 2018: Journal of the American College of Cardiology
Kevin M Veen, Rahatullah Muslem, Osama I Soliman, Kadir Caliskan, Marit E A Kolff, Dagmar Dousma, Olivier C Manintveld, Ozcan Birim, Ad J J C Bogers, Johanna J M Takkenberg
OBJECTIVES: Moderate-to-severe tricuspid regurgitation is common in end-stage heart disease and is associated with an impaired survival after left ventricular assist device (LVAD) surgery. Controversy remains whether concomitant tricuspid valve surgery (TVS) during LVAD implantation is beneficial. We aimed to provide a contemporary overview of outcomes in patients who underwent LVAD surgery with or without concomitant TVS. METHODS: A systematic literature search was performed for articles published between January 2005 and March 2017...
April 20, 2018: European Journal of Cardio-thoracic Surgery
Frederik Beckhoff, Brunilda Alushi, Christian Jung, Eliano Navarese, Marcus Franz, Daniel Kretzschmar, Bernhard Wernly, Michael Lichtenauer, Alexander Lauten
Severe tricuspid regurgitation (TR) is a complex condition of the right ventricle (RV) and tricuspid valve apparatus and is frequently associated with symptomatic heart failure and a significant morbidity and mortality. In these patients, left heart pathologies lead to chronic pressure overload of the RV, eventually causing progressive RV dilatation and functional TR. Therefore, TR cannot be considered as isolated heart valve disease pathology but has to be understood and treated as one component of a complex structural RV pathology and is frequently also a marker of an advanced stage of cardiac disease...
2018: Frontiers in Cardiovascular Medicine
C C Pang, W Pan, Z W Zhang, C B Zhou, Y F Li, X Zhang, F Z Han, Y X Sun, S Wang, J Zhuang
Objectives: Two cases who underwent fetal pulmonary valvuloplasty (FPV) for pulmonary atresia with intact ventricular septum (PA-IVS) or critical pulmonary stenosis with intact ventricular septum (CPS-IVS) successfully were reported. The aim of the report was to explore the criteria for case selection, the technical essentials of FPV, and the postpartum outcome of the fetus. Methods: One case with PA-IVS and the other with CPS-IVS were enrolled in September 2016 and February 2017 in Guangdong General Hospital, and both cases were diagnosed with severe right ventricular dysplasia and tricuspid regurgitation by fetal echocardiogram...
June 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Akira Furutachi, Kojiro Furukawa, Kouta Shimauchi, Junji Yunoki, Manabu Itoh, Masanori Takamatsu, Eijiro Nogami, Yosuke Mukae, Takahiro Nishida
We report a case of a 66-year-old man who was diagnosed with severe aortic regurgitation, moderate tricuspid regurgitation and chronic atrial fibrillation. Preoperative computed tomography showed left lung agenesis. We performed aortic valve replacement, tricuspid valve annuloplasty and right pulmonary vein isolation via a left thoracotomy. This approach provided an adequate field of view.
June 6, 2018: General Thoracic and Cardiovascular Surgery
Alina Cristina Iliescu, Delia Lidia Salaru, Ionut Achitei, Mihaela Grecu, Mariana Floria, Grigore Tinica
OBJECTIVE: Postoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, with increased risk of stroke and high mortality. Our aim was to identify patients at risk and to design a model that could predict POAF. METHODS: In this single center study, we evaluated 1191 patients requiring isolated surgical aortic valve replacement between January 2000 and June 2014. The patients were followed during the early postoperative period until discharge...
June 2018: Anatolian Journal of Cardiology
Gonçalo F Coutinho, Jose M Martínez Cereijo, Pedro M Correia, Catarina S Lopes, Laura Reija López, Dario Durán Muñoz, Manuel J Antunes
OBJECTIVES: The reported superiority of mitral valve (MV) repair for isolated MV regurgitation has not been confirmed in mitroaortic valve surgery. Our goals were to evaluate the feasibility of repair in patients undergoing mitral and aortic valve surgery and to identify factors predisposing to MV replacement, to compare long-term outcomes (survival and MV reoperation) of repair and replacement and to perform a subgroup analysis in patients with rheumatic MV disease. METHODS: From January 1992 through December 2016, 1122 consecutive patients were submitted to concomitant aortic and MV surgery in 2 different centres (Coimbra and Santiago)...
May 25, 2018: European Journal of Cardio-thoracic Surgery
Chris C Cook, Muhammed Salman, Lawrence M Wei, Harold G Roberts, Vinay Badhwar
No abstract text is available yet for this article.
August 2018: Journal of Thoracic and Cardiovascular Surgery
Xiaoyan Gu, Ye Zhang, Jiancheng Han, Xiaowei Liu, Shuping Ge, Yihua He
BACKGROUND: Premature restriction or closure of foramen ovale (FO) in otherwise structurally normal hearts may be associated with right ventricular dilation, tricuspid regurgitation, pericardial effusion, heart failure, even poor perinatal outcomes. Data about these rare conditions are lacking. METHODS: We retrospectively reviewed the echocardiographic records of 9704 fetuses seen from 2010 to 2014 in Beijing Anzhen Hospital, a regional and national referral center, to ascertain the presence of restriction or closure of FO...
May 14, 2018: Echocardiography
Julien Dreyfus, Nicolas Ghalem, Eric Garbarz, Claire Cimadevilla, Patrick Nataf, Alec Vahanian, Gilbert Caranhac, David Messika-Zeitoun
Series evaluating the results of isolated tricuspid valve surgery (ITVS) are rare and often limited by small sample size, selection bias, and/or long period of enrollment. Based on a mandatory administrative national database, we collected all consecutive ITVS performed in France during a 2-year period (2013 and 2014), the type of intervention, clinical profile, and in-hospital mortality and complications. During the 2-year period, 241 patients underwent an ITVS in France (84 repairs and 157 replacements). In-hospital mortality was high (10%), and most patients experienced at least 1 complication (65%) with a 19% rate of major complications (death, need for dialysis, or need for mechanical support using extracorporeal membrane oxygenation)...
July 15, 2018: American Journal of Cardiology
Daniel Braun, Michael Nabauer, Mathias Orban, Andrea Englmaier, Diana Rösler, Christian Hagl, Steffen Massberg, Jörg Hausleiter
No abstract text is available yet for this article.
July 20, 2018: EuroIntervention
Jörg Hausleiter, Daniel Braun, Mathias Orban, Azeem Latib, Philipp Lurz, Peter Boekstegers, Ralph Stephan von Bardeleben, Marek Kowalski, Rebecca T Hahn, Francesco Maisano, Christian Hagl, Steffen Massberg, Michael Nabauer
Severe tricuspid regurgitation (TR) has long been neglected despite its well known association with mortality. While surgical mortality rates remain high in isolated tricuspid valve surgery, interventional TR repair is rapidly evolving as an alternative to cardiac surgery in selected patients at high surgical risk. Currently, interventional edge-to-edge repair is the most frequently applied technique for TR repair even though the device has not been developed for this particular indication. Due to the inherent differences in tricuspid and mitral valve anatomy and pathology, percutaneous repair of the tricuspid valve is challenging due to a variety of factors including the complexity and variability of tricuspid valve anatomy, echocardiographic visibility of the valve leaflets, and device steering to the tricuspid valve...
April 24, 2018: EuroIntervention
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