Tricuspid regurgitation natural history, complications and prognosis: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
Moderate and severe TR are associated with an increased morbidity and mortality.<ref name="pmid3657250">{{cite journal| author=Cohen SR, Sell JE, McIntosh CL, Clark RE| title=Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. I. Prevalence, diagnosis, and comparison of preoperative clinical and hemodynamic features in patients with and without tricuspid regurgitation. | journal=J Thorac Cardiovasc Surg | year= 1987 | volume= 94 | issue= 4 | pages= 481-7 | pmid=3657250 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3657250 }} </ref> | Moderate and severe TR are associated with an increased morbidity and mortality.<ref name="pmid22340261">{{cite journal| author=Taramasso M, Vanermen H, Maisano F, Guidotti A, La Canna G, Alfieri O| title=The growing clinical importance of secondary tricuspid regurgitation. | journal=J Am Coll Cardiol | year= 2012 | volume= 59 | issue= 8 | pages= 703-10 | pmid=22340261 | doi=10.1016/j.jacc.2011.09.069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22340261 }} </ref><ref name="pmid3657250">{{cite journal| author=Cohen SR, Sell JE, McIntosh CL, Clark RE| title=Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. I. Prevalence, diagnosis, and comparison of preoperative clinical and hemodynamic features in patients with and without tricuspid regurgitation. | journal=J Thorac Cardiovasc Surg | year= 1987 | volume= 94 | issue= 4 | pages= 481-7 | pmid=3657250 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3657250 }} </ref> | ||
TR commonly occurs among patients with mild/moderate [[mitral regurgitation]] (MR) or [[mitral stenosis]]. Approximately 30-50% of patients with [[MR]] have concomitant TR.<ref name="pmid3657251">{{cite journal| author=Cohen SR, Sell JE, McIntosh CL, Clark RE| title=Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. II. Nonoperative management, tricuspid valve annuloplasty, and tricuspid valve replacement. | journal=J Thorac Cardiovasc Surg | year= 1987 | volume= 94 | issue= 4 | pages= 488-97 | pmid=3657251 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3657251 }} </ref><ref name="pmid3657250">{{cite journal| author=Cohen SR, Sell JE, McIntosh CL, Clark RE| title=Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. I. Prevalence, diagnosis, and comparison of preoperative clinical and hemodynamic features in patients with and without tricuspid regurgitation. | journal=J Thorac Cardiovasc Surg | year= 1987 | volume= 94 | issue= 4 | pages= 481-7 | pmid=3657250 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3657250 }} </ref> Isolated [[mitral valve surgery]] for mitral valve abnormalities is associated with no improvement of TR in the majority of patients.<ref name="pmid7934109">{{cite journal| author=Sagie A, Schwammenthal E, Palacios IF, King ME, Leavitt M, Freitas N et al.| title=Significant tricuspid regurgitation does not resolve after percutaneous balloon mitral valvotomy. | journal=J Thorac Cardiovasc Surg | year= 1994 | volume= 108 | issue= 4 | pages= 727-35 | pmid=7934109 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7934109 }} </ref> Tricuspid valve surgery at the time of operation for left-sided valvulopathy significantly decreases the rate of post-operative residual MR.<ref name="pmid9576162">{{cite journal| author=Tager R, Skudicky D, Mueller U, Essop R, Hammond G, Sareli P| title=Long-term follow-up of rheumatic patients undergoing left-sided valve replacement with tricuspid annuloplasty--validity of preoperative echocardiographic criteria in the decision to perform tricuspid annuloplasty. | journal=Am J Cardiol | year= 1998 | volume= 81 | issue= 8 | pages= 1013-6 | pmid=9576162 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9576162 }} </ref> | TR commonly occurs among patients with mild/moderate [[mitral regurgitation]] (MR) or [[mitral stenosis]]. Approximately 30-50% of patients with [[MR]] have concomitant TR.<ref name="pmid3657251">{{cite journal| author=Cohen SR, Sell JE, McIntosh CL, Clark RE| title=Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. II. Nonoperative management, tricuspid valve annuloplasty, and tricuspid valve replacement. | journal=J Thorac Cardiovasc Surg | year= 1987 | volume= 94 | issue= 4 | pages= 488-97 | pmid=3657251 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3657251 }} </ref><ref name="pmid3657250">{{cite journal| author=Cohen SR, Sell JE, McIntosh CL, Clark RE| title=Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. I. Prevalence, diagnosis, and comparison of preoperative clinical and hemodynamic features in patients with and without tricuspid regurgitation. | journal=J Thorac Cardiovasc Surg | year= 1987 | volume= 94 | issue= 4 | pages= 481-7 | pmid=3657250 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3657250 }} </ref> Isolated [[mitral valve surgery]] for mitral valve abnormalities is associated with no improvement of TR in the majority of patients.<ref name="pmid7934109">{{cite journal| author=Sagie A, Schwammenthal E, Palacios IF, King ME, Leavitt M, Freitas N et al.| title=Significant tricuspid regurgitation does not resolve after percutaneous balloon mitral valvotomy. | journal=J Thorac Cardiovasc Surg | year= 1994 | volume= 108 | issue= 4 | pages= 727-35 | pmid=7934109 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7934109 }} </ref> Tricuspid valve surgery at the time of operation for left-sided valvulopathy significantly decreases the rate of post-operative residual MR.<ref name="pmid9576162">{{cite journal| author=Tager R, Skudicky D, Mueller U, Essop R, Hammond G, Sareli P| title=Long-term follow-up of rheumatic patients undergoing left-sided valve replacement with tricuspid annuloplasty--validity of preoperative echocardiographic criteria in the decision to perform tricuspid annuloplasty. | journal=Am J Cardiol | year= 1998 | volume= 81 | issue= 8 | pages= 1013-6 | pmid=9576162 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9576162 }} </ref> |
Revision as of 16:06, 10 September 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
The majority of tricuspid regurgitation remain asymptomatic.
Natural History
Complications
Prognosis
Moderate and severe TR are associated with an increased morbidity and mortality.[1][2]
TR commonly occurs among patients with mild/moderate mitral regurgitation (MR) or mitral stenosis. Approximately 30-50% of patients with MR have concomitant TR.[3][2] Isolated mitral valve surgery for mitral valve abnormalities is associated with no improvement of TR in the majority of patients.[4] Tricuspid valve surgery at the time of operation for left-sided valvulopathy significantly decreases the rate of post-operative residual MR.[5]
Factors associated with postoperative residual TR following isolated mitral valve surgery among patients with MR and concomitant TR include:[6]
- Excessively dilated left atrium
- Atrial fibrillation
- Preoperative TR (2+)
References
- ↑ Taramasso M, Vanermen H, Maisano F, Guidotti A, La Canna G, Alfieri O (2012). "The growing clinical importance of secondary tricuspid regurgitation". J Am Coll Cardiol. 59 (8): 703–10. doi:10.1016/j.jacc.2011.09.069. PMID 22340261.
- ↑ 2.0 2.1 Cohen SR, Sell JE, McIntosh CL, Clark RE (1987). "Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. I. Prevalence, diagnosis, and comparison of preoperative clinical and hemodynamic features in patients with and without tricuspid regurgitation". J Thorac Cardiovasc Surg. 94 (4): 481–7. PMID 3657250.
- ↑ Cohen SR, Sell JE, McIntosh CL, Clark RE (1987). "Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. II. Nonoperative management, tricuspid valve annuloplasty, and tricuspid valve replacement". J Thorac Cardiovasc Surg. 94 (4): 488–97. PMID 3657251.
- ↑ Sagie A, Schwammenthal E, Palacios IF, King ME, Leavitt M, Freitas N; et al. (1994). "Significant tricuspid regurgitation does not resolve after percutaneous balloon mitral valvotomy". J Thorac Cardiovasc Surg. 108 (4): 727–35. PMID 7934109.
- ↑ Tager R, Skudicky D, Mueller U, Essop R, Hammond G, Sareli P (1998). "Long-term follow-up of rheumatic patients undergoing left-sided valve replacement with tricuspid annuloplasty--validity of preoperative echocardiographic criteria in the decision to perform tricuspid annuloplasty". Am J Cardiol. 81 (8): 1013–6. PMID 9576162.
- ↑ Matsuyama K, Matsumoto M, Sugita T, Nishizawa J, Tokuda Y, Matsuo T (2003). "Predictors of residual tricuspid regurgitation after mitral valve surgery". Ann Thorac Surg. 75 (6): 1826–8. PMID 12822623.