Appraisal of rheumatic tricuspid stenosis.
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A 57-year-old woman, who underwent aortic valve replacement and open mitral commissurotomy nine years ago, was admitted with congestive heart failure due to mitral regurgitation and tricuspid regurgitation, for which we planned mitral valve replacement and tricuspid annuloplasty. Intraoperatively, the orifice of tricuspid valve was stenosed like fish-mouth, which we attempted to make commissurotomy and modified Kay's annuloplasty, but failed to decrease the central regurgitation. A CarboMedics 23 mm prosthesis was implanted in the mitral position and a Capentier-Edwards 29 mm in the tricuspid position. She had recovered from congestive heart failure postoperatively, no regurgitant flow was detected in right ventriculography.
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Nonspecific constitutional symptoms are reported mostly in patients with left-atrial myxomas, which occur five times as often as its right-atrial counterpart. We present huge right-atrial myxoma, which obstructs tricuspid orifice with nonspecific constitutional symptoms without any pulmonary embolism attack.
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