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PubMed1991

Role of echocardiography in the diagnosis and evaluation of severity of mitral and tricuspid stenosis.

The presence, severity, and hemodynamic consequences of mitral and tricuspid stenosis can be determined by echocardiographic techniques. In mitral stenosis two-dimensional echocardiographic imaging allows definition of leaflet anatomy and dynamics, subvalvular disease, ventricular function, and involvement of other valves. Spectral and color Doppler echocardiographic techniques permit accurate measurement of transvalvular gradient, determination of functional orifice area, evaluation of associated valvular regurgitation, and assessment of pulmonary artery pressures. These approaches are of recognized clinical value, and they provide additional diagnostic information that is unavailable from clinical assessment alone in a significant number of patients. Compared with available invasive diagnostic standards of reference, echocardiographic data have been found to be comparable in accuracy. In tricuspid stenosis echocardiographic imaging and Doppler techniques provide an assessment of valve morphology and function that should be similarly useful in clinical management decisions, although rigorous comparative studies have not been performed. Currently, carefully done echocardiographic studies are a definitive means of establishing the presence and significance of mitral stenosis and tricuspid stenosis, thereby obviating the need for invasive evaluation in many patients, reducing risk, and potentially decreasing the cost of diagnostic assessment.

Echocardiography↗
PubMedDate not supplied

Tricuspid stenosis: a rare cause of heart failure in the United States.

The authors describe the case of a 72-year-old patient who has a history of rheumatic heart disease and had mitral valve replacement in childhood. She presents with progressive right-sided heart failure unresponsive to medical therapy. On evaluation she was found to have severe aortic stenosis and severe tricuspid stenosis. Surgical correction of both valves resulted in complete resolution of heart failure with remarkable improvement in quality of life. The symptoms, physical findings, and treatment options will be discussed.

Aged↗
PubMed1990

[A rare case of congenital tricuspid stenosis treated with modified Fontan operation].

A rare case of congenital tricuspid stenosis treated with modified Fontan operation was reported. The patient was 13 years old boy and his chief complaint was cyanosis. Cyanosis appeared in his neonatal period and squatting developed in his childhood. He underwent Blalock's shunt operation at 5 years of age. His exercise tolerance was limited at the admission for the radical operation. Angiocardiography showed the annular stenosis of tricuspid valve and the moderate hypoplasia of right ventricle. The right ventricular volume was 56 ml (equivalent to 35% of the normally expected right ventricular volume) and the diameter of tricuspid annulus was 13 mm (equivalent to 58% of the normally expected diameter). Atrial septal defect was associated with but pulmonary stenosis did not exist. His left ventricular function was good and pulmonary vascular resistance was not raised. A diagnosis of tricuspid stenosis was made and Fontan's repair was considered to be possible for his correction. Operative findings showed normal architecture of tricuspid valve with the three leaflets but tricuspid annulus was narrow. Tricuspid valve stenosis was considered to be caused by the hypoplasia of tricuspid ring and surgical dilatation was found to be difficult. Therefore, modified Fontan operation (RA-RV connection) was performed. His cyanosis disappeared and exercise tolerance was improved after the operation. Cardiac catheterization and angiocardiography were performed 8 months and 28 months after the operation. His righ ventricular volume was increased to 123 ml (equivalent to 57% of the normally expected volume) followed by RA-RV connection.

Adolescent↗
PubMed1998

Bicuspidization for tricuspid stenosis.

Bicuspidization technique for rheumatic tricuspid stenosis based on the concept that the tricuspid valve has a straight (septal) and a curved (mural) leaflet is described. The fused commissures on either side of the septal leaflet are divided, resulting in separation of the two leaflets. The related anatomic and pathologic features are discussed.

Adult↗
PubMed1983

Value of two-dimensional echocardiography in detecting tricuspid stenosis.

We reviewed the M-mode and two-dimensional echocardiograms of 100 consecutive patients with rheumatic heart disease. All were subsequently studied by cardiac catheterization and angiography. In four patients, cardiac catheterization showed tricuspid stenosis (average mean diastolic gradient 6.2 mm Hg), which was confirmed during cardiac surgery. M-mode echocardiography showed a diminished EF slope in 12 patients (mean 26 mm/sec), including the four patients with tricuspid stenosis. Seven of the eight patients without tricuspid stenosis had significant pulmonary hypertension; the reasons for the diminished EF slope in the other patient could not be identified. Tricuspid stenosis was diagnosed in four patients from two-dimensional echocardiograms on the basis of diastolic doming and restricted leaflet motion of the tricuspid valve. These four patients were the same patients in whom tricuspid stenosis was diagnosed by cardiac catheterization. We conclude that two-dimensional echocardiography is useful in the diagnosis of tricuspid stenosis.

Adult↗
PubMed2002

[Tricuspid stenosis after pacemaker implantation without evidence of bacterial endocarditis. A case report].

Tricuspid stenosis related to endocardial pacemaker leads is uncommon. We report the case of a patient with severe tricuspid stenosis documented 15 years after the implantation of a permanent DDD pacemaker for symptomatic congenital heart block. The atrial and ventricular leads both had a loop at the level of the tricuspid valve that may have caused endothelial damage and, eventually, tricuspid stenosis.

Adult↗
PubMed1978

Rheumatic tricuspid stenosis. A clinical overview.

The clinical, hemodynamic findings and surgical results of forty patients with rheumatic tricuspid stenosis are presented. It is concluded that tricuspid stenosis is a frequent lesion. Its signs should be sought carefully and documented by simultaneous measurements of the right ventricular diastolic and right atrial pressures. Tricuspid stenosis is usually associated with other valvular lesions, whose clinical and hemodynamic findings might be altered. Surgical procedures on these patients involved tricuspid valve repair, commissurotomy or prosthetic valve replacement, in addition to the procedures necessary to correct other associated valvular lesions. Results of surgery were gratifying with significant improvement in 87 percent of patients and a mortality of 3 per cent.

Adolescent↗