[Diagnosis of tricuspid stenosis during mitral stenosis].
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A total of 500 patients with mitral stenosis subjected to mitral commissurotomy were examined 1 to 14 years after surgery. Relative tricuspid insufficiency accompanying mitral stenosis was detected preoperatively in 104 patients (20.8%). The authors concluded that it was rationale to undertake mitral commissurotomy in such patients after careful preoperative preparation, and to treat them medically afterwards. The follow-up analysis demonstrated that good results of surgery were achieved in 32 cases (30.8%), satisfactory--in 60 (56.7%), poor--in 11 (10.5%). One patient died after surgery for mitral re-stenosis. A comparison of 2 groups of patients--Group 1 with mitral stenosis and relative tricuspid valve insufficiency, and Group 2 with mitral stenosis alone without tricuspid insufficiency--revealed that the late results were better in Group 1. To maintain the positive effect of surgery in all the cases preventive anti-rheumatism measures should be taken the year round.
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The case is presented of a patient with congenital tricuspid stenosis who was treated successfully by a palliative open operation. The preoperative diagnosis was tricuspid atresia. At operation, however, congenital tricuspid stenosis was detected and managed by commissurotomy.. The postoperative course was very good. Later, the associated ventricular septal defect (VSD), pulmonary annular stenosis, and probably the atrial septal defect (ASD) will be corrected. We emphasize the importance of diagnosing congenital tricuspid stenosis correctly, because of the possibility of operating upon the valve itself.
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Isolated congenital tricuspid valve stenosis is a rare entity. The modalities of definitive treatment have been surgical repair or replacement. We present the first reported patient with congenital tricuspid stenosis successfully treated by percutaneous balloon valvotomy. This appears to be an alternative to surgery when the anatomy, as demonstrated by echocardiography, is suitable.
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