scholarly journals TCT-339 Impact of Tricuspid Regurgitation on Thermodilution for Measurement of Cardiac Index

2021 ◽  
Vol 78 (19) ◽  
pp. B138-B139
Author(s):  
Michael Sternberg ◽  
Joseph Nicolazzi ◽  
Murti Patel ◽  
Jonathan Saado ◽  
Sara Kwiatkowski ◽  
...  
Keyword(s):  
Cardiac Index ◽  
Tricuspid Regurgitation

Impact of New Grading System and New Hemodynamic Classification on Long-Term Outcome in Patients With Severe Tricuspid Regurgitation

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Taku Omori ◽  
Goki Uno ◽  
Shunsuke Shimada ◽  
Florian Rader ◽  
Robert J. Siegel ◽  
...  
Keyword(s):  
Cardiac Index ◽  
Tricuspid Regurgitation ◽  
Cardiovascular Events ◽  
Right Heart Catheterization ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Right Atrial Pressure ◽  
Heart Catheterization ◽  
Grading System ◽  
Right Heart

Background: A new grading of tricuspid regurgitation (TR) beyond severe has been proposed. However, few studies assessing the validity of such a new grading scheme of TR have been conducted. Therefore, we evaluated associations of TR grades beyond severe with patient outcome and hemodynamics. Methods: We retrospectively studied patients who underwent 2-dimensional echocardiography and were diagnosed with severe TR between January 2014 and December 2015. According to the vena contracta width of TR (VC), the patients were classified into 2 groups: VC under 14 mm (VC<14 mm) and VC 14 mm or greater (VC≥14 mm). Hemodynamic parameters were estimated by echocardiography and were obtained by right heart catheterization. Cardiovascular events were defined as cardiovascular death or admission for heart failure. Results: A total of 679 patients (mean 72±17 years, 56% women) were included. During follow-up (median, 158 days; range, 29–891), 210 patients experienced cardiovascular events. By multivariate analysis, VC≥14 mm and left ventricular ejection fraction were independent predictors of cardiovascular events (hazard ratio, 1.57 [1.06–2.33]; hazard ratio, 0.99 [0.98–0.99], respectively). Patients with VC≥14 mm had significantly lower cardiac index (median, 1.8 versus 2.1 L/min per m 2 , P =0.001) and a higher prevalence of right atrial pressure 15 mm Hg (74% versus 60%, P <0.001) on echocardiography. Also, right heart catheterization confirmed higher right atrial pressure in patients with VC≥14 mm than those with VC<14 mm (16±8 versus 12±6 mm Hg, P =0.004). The new subset classification developed by cardiac index and right atrial pressure both on echocardiography predicted cardiovascular events (Log-rank P <0.001). Conclusions: The relationship of VC≥14 mm to adverse outcome and poor hemodynamics showed the clinical relevance and need of a new grading system beyond severe. The new hemodynamic subset classification provides additional prognostic value for cardiovascular events in patients with severe TR.

Curious Case of Mitral and Tricuspid Regurgitation

2020 ◽  
Author(s):  
Syed Hamza Mufarrih ◽  
Nada Qaisar Qureshi ◽  
Kamal R. Khabbaz ◽  
Feroze Mahmood ◽  
Aidan Sharkey
Keyword(s):  
Tricuspid Regurgitation

Tricuspid Valve Anterior Leaflet Strains in Ovine Functional Tricuspid Regurgitation

2020 ◽  
Author(s):  
Tomasz Jazwiec ◽  
Marcin J. Malinowski ◽  
Haley Ferguson ◽  
Jessica Parker ◽  
Mrudang Mathur ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Anterior Leaflet ◽  
Functional Tricuspid Regurgitation

Does low cardiac index predict a negative outcome in patients undergoing cardiac surgery?

2010 ◽  
Vol 58 (S 01) ◽  
Author(s):  
A Lehmann ◽  
AH Kiessling ◽  
P Schmuck ◽  
F Isgro ◽  
J Boldt ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Index ◽  
Negative Outcome

The Hemodynamic and Fibrinolytic Response to Low Dose Epinephrine and Phenylephrine Infusions During Total Hip Replacement Under Epidural Anesthesia

1992 ◽  
Vol 68 (04) ◽  
pp. 436-441 ◽  
Author(s):  
Nigel E Sharrock ◽  
George Go ◽  
Robert Mineo ◽  
Peter C Harpel
Keyword(s):  
Heart Rate ◽  
Deep Vein Thrombosis ◽  
Cardiac Index ◽  
Total Hip Replacement ◽  
Epidural Anesthesia ◽  
Hip Replacement ◽  
Low Dose ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryLower rates of deep vein thrombosis have been noted following total hip replacement under epidural anesthesia in patients receiving exogenous epinephrine throughout surgery. To determine whether this is due to enhanced fibrinolysis or to circulatory effects of epinephrine, 30 patients scheduled for primary total hip replacement under epidural anesthesia were randomly assigned to receive intravenous infusions of either low dose epinephrine or phenylephrine intraoperatively. All patients received lumbar epidural anesthesia with induced hypotension and were monitored with radial artery and pulmonary artery catheters.Patients receiving low dose epinephrine infusion had maintenance of heart rate and cardiac index whereas both heart rate and cardiac index declined significantly throughout surgery in patients receiving phenylephrine (p = 0.0001 and p = 0.0001, respectively). Tissue plasminogen activator (t-PA) activity increased significantly during surgery (p <0.0005) and declined below baseline postoperatively (p <0.005) in both groups. Low dose epinephrine was not associated with any additional augmentation of fibrinolytic activity perioperatively. There were no significant differences in changes in D-Dimer, t-PA antigen, α2-plasmin inhibitor-plasmin complexes or thrombin-antithrombin III complexes perioperatively between groups receiving low dose epinephrine or phenylephrine. The reduction in deep vein thrombosis rate with low dose epinephrine is more likely mediated by a circulatory mechanism than by augmentation of fibrinolysis.

Surgical Strategy in Patients with Atrial Septal Defect and Severe Pulmonary Hypertension

2012 ◽  
Vol 15 (2) ◽  
pp. 111 ◽  
Author(s):  
Yang Hyun Cho ◽  
Tae-Gook Jun ◽  
Ji-Hyuk Yang ◽  
Pyo Won Park ◽  
June Huh ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Maze Procedure ◽  
Severe Pulmonary Hypertension ◽  
Tricuspid Annuloplasty ◽  
Pulmonary Arterial ◽  
Asd Closure

The aim of the study was to review our experience with atrial septal defect (ASD) closure with a fenestrated patch in patients with severe pulmonary hypertension. Between July 2004 and February 2009, 16 patients with isolated ASD underwent closure with a fenestrated patch. All patients had a secundum type ASD and severe pulmonary hypertension. Patients ranged in age from 6 to 57 years (mean � SD, 34.9 � 13.5 years). The follow-up period was 9 to 59 months (mean, 34.5 � 13.1 months). The ranges of preoperative systolic and pulmonary arterial pressures were 63 to 119 mm Hg (mean, 83.8 � 13.9 mm Hg) and 37 to 77 mm Hg (mean, 51.1 � 10.1 mm Hg). The ranges of preoperative values for the ratio of the pulmonary flow to the systemic flow and for pulmonary arterial resistance were 1.1 to 2.7 (mean, 1.95 � 0.5) and 3.9 to 16.7 Wood units (mean, 9.8 � 2.9 Wood units), respectively. There was no early or late mortality. Tricuspid annuloplasty was performed in 14 patients (87.5%). The peak tricuspid regurgitation gradient and the ratio of the systolic pulmonary artery pressure to the systemic arterial pressure were decreased in all patients. The New York Heart Association class and the grade of tricuspid regurgitation were improved in 13 patients (81.2%) and 15 patients (93.7%), respectively. ASD closure in patients with severe pulmonary hypertension can be performed safely if we create fenestration. Tricuspid annuloplasty and a Cox maze procedure may improve the clinical result. Close observation and follow-up will be needed to validate the long-term benefits.

Outcomes of De Vega versus Biodegradable Ring Annuloplasty in the Surgical Treatment of Tricuspid Regurgitation (Mid-term Results)

2010 ◽  
Vol 13 (4) ◽  
pp. E233-E237 ◽  
Author(s):  
Halil Basel ◽  
Unal Aydin ◽  
Hakan Kutlu ◽  
Aysenur Dostbil ◽  
Melike Karadag ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Tricuspid Regurgitation ◽  
Ring Annuloplasty ◽  
Mid Term Results

Perimeter of The Tricuspid Valve: A Cadaveric Human Heart Study

2020 ◽  
Vol 11 (3) ◽  
pp. 3424-3428
Author(s):  
Kirti Chaudhary ◽  
Amey Dhatrak ◽  
Brij Raj Singh ◽  
Ujwal Gajbe
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Right Ventricular Dysfunction ◽  
Mean Value ◽  
Female Population ◽  
Functional Tricuspid Regurgitation ◽  
Lv Dysfunction ◽  
Heart Study ◽  
Males And Females ◽  
The Right

Historically, the research on the right ventricle (RV) has been neglected by his left equivalent because of the complexity of left ventricle (LV) dysfunction. Tricuspid regurgitation (TR) can be classified as linked to primary valve disease or functional in nature, but most are functional. Although it was historically assumed that such functional Tricuspid regurgitation, i.e. arising from leftsided disease, and it can be resolved after corrective surgery, but after successful surgery, on the aortic or mitral valve annular dilatation, the Tricuspid regurgitation and right ventricular dysfunction may persist.To study the circumference of tricuspid orifice and it’s the diameter in two perpendicular planes and its comparison among the male and female population. The material for the present study comprised of 50 formalin fixed human hearts (35 males and 15 females) which were obtained from the department of anatomy. In this study, it is observed that: The mean value of circumference of a tricuspid orifice is 11.01+/-0.63 cm. The diameter of tricuspid orifice along the frontal dimension is 3.06+/-0.38 cm, and the diameter along the sagittal dimension is 2.26+/-0.23 cm. The measurements of the circumference of tricuspid orifice reported for males and females in western countries were higher than the present study and the diameter along the frontal dimension is greater than the diameter along the sagittal dimension. The tricuspid valve diameter along the frontal dimension was more than the diameter along the sagittal dimension in both males and females.

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