Increased Risk of Possible Paradoxical Embolic Events in Adults with Ebstein Anomaly and Severe Tricuspid Regurgitation

2013 ◽  
Vol 9 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Christine H. Attenhofer Jost ◽  
Heidi M. Connolly ◽  
Christopher G. Scott ◽  
Harold M. Burkhart ◽  
Naser M. Ammash ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Ebstein Anomaly ◽  
Severe Tricuspid Regurgitation ◽  
Increased Risk

Ebstein anomaly combined with unique pulmonary venous abnormality in a 9-month-old child

2020 ◽  
Vol 30 (7) ◽  
pp. 1026-1028
Author(s):  
Emily N. Sanders ◽  
Dala Zakaria
Keyword(s):  
Pulmonary Hypertension ◽  
Tricuspid Regurgitation ◽  
Wide Spectrum ◽  
Delayed Diagnosis ◽  
Medical Attention ◽  
Ebstein Anomaly ◽  
Severe Tricuspid Regurgitation ◽  
Age Of Diagnosis

AbstractEbstein anomaly is a rare CHD known for its wide spectrum of presentation with the age of diagnosis dependent on the malformation’s severity. Here, the authors describe a case of delayed diagnosis of Ebstein anomaly, secondary to lack of medical attention, which resulted in severe tricuspid regurgitation and pulmonary hypertension. Furthermore, the case was complicated by a unique pulmonary venous abnormality.

scholarly journals Transcatheter Tricuspid Valve Intervention in Patients With Right Ventricular Dysfunction or Pulmonary Hypertension

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Guillem Muntané-Carol ◽  
Maurizio Taramasso ◽  
Mizuki Miura ◽  
Mara Gavazzoni ◽  
Alberto Pozzoli ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Hazard Ratio ◽  
Severe Tricuspid Regurgitation ◽  
Increased Risk ◽  
Procedural Success

Background: Scarce data exist on patients with right ventricular dysfunction (RVD) or pulmonary hypertension (PH) undergoing transcatheter tricuspid valve intervention. This study aimed to determine the early and midterm outcomes and the factors associated with mortality in this group of patients. Methods: This subanalysis of the multicenter TriValve (Transcatheter Tricuspid Valve Therapies) registry included 300 patients with severe tricuspid regurgitation with RVD (n=244), PH (n=127), or both (n=71) undergoing transcatheter tricuspid valve intervention. RVD was defined as a tricuspid annular plane systolic excursion <17 mm, and PH as an estimated pulmonary artery systolic pressure ≥50 mm Hg. Results: Mean age of the patients was 77±9 years (54% women). Procedural success was 80.7%, and 9 patients (3%) died during the hospitalization. At a median follow-up of 6 (interquartile range, 2–12) months, 54 patients (18%) died, and the independent associated factors were higher gamma-glutamyl transferase values at baseline (hazard ratio, 1.02 for each increase of 10 u/L [95% CI, 1.002–1.04]), poorer renal function defined as an estimated glomerular filtration rate <45 mL/min (hazard ratio, 2.3 [95% CI, 1.22–4.33]), and the lack of procedural success (hazard ratio, 2.11 [95% CI, 1.17–3.81]). The grade of RVD and the amount of PH at baseline were not found to be predictors of mortality. Most patients alive at follow-up improved their functional class (New York Heart Association I–II in 66% versus 7% at baseline, P <0.001). Conclusions: In patients with severe tricuspid regurgitation and RVD/PH, transcatheter tricuspid valve intervention was associated with high procedural success and a relatively low in-hospital mortality, along with significant improvements in functional status. However, about 1 out of 5 patients died after a median follow-up of 6 months, with hepatic congestion, renal dysfunction, and the lack of procedural success determining an increased risk. These results may improve the clinical evaluation of transcatheter tricuspid valve intervention candidates and would suggest a closer follow-up in those at increased risk. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03416166.

scholarly journals Haemodynamic determinants of improved aerobic capacity after tricuspid valve surgery in Ebstein anomaly

Heart ◽  
2020 ◽  
pp. heartjnl-2020-317756
Author(s):  
Alexander Egbe ◽  
William Miranda ◽  
Heidi Connolly ◽  
Joseph Dearani
Keyword(s):  
Relative Risk ◽  
Tricuspid Valve ◽  
Aerobic Capacity ◽  
Tricuspid Regurgitation ◽  
Valve Surgery ◽  
Ebstein Anomaly ◽  
Severe Tricuspid Regurgitation ◽  
Tricuspid Valve Surgery ◽  
Postoperative Improvement

BackgroundAlthough tricuspid valve surgery improves functional capacity in patients with Ebstein anomaly, it is not always associated with improvement in aerobic capacity. The purpose of this study was to identify the determinants of improved aerobic capacity after tricuspid valve surgery in adults with Ebstein anomaly with severe tricuspid regurgitation.MethodsRetrospective study of patients with severe tricuspid regurgitation due to Ebstein anomaly that had tricuspid valve surgery at Mayo Clinic Rochester (2000–2019) and had preoperative and postoperative cardiopulmonary exercise tests and echocardiograms. The patients were divided into aerobic capacity(+) and aerobic capacity(-) groups depending on whether they had postoperative improvement in %-predicted peak oxygen consumption (VO2).ResultsOf 76 patients with severe tricuspid regurgitation due to Ebstein anomaly, 28 (37%) and 48 (63%) were in aerobic capacity(+) and aerobic capacity(-) groups, respectively. The average improvement in peak VO2 was 2.1±1.4 mL/kg/min and −0.9±0.4 mL/kg/min in the in aerobic capacity(+) and aerobic capacity(-) groups, respectively. Although both groups had similar severity of residual tricuspid regurgitation, the aerobic capacity(+) group had more postoperative improvement in right atrial (RA) function, left atrial (LA) function and left ventricular preload and stroke volume. Of the preoperative variables analysed, RA reservoir strain (relative risk 1.12; 95% CI 1.06 to 1.18); LA reservoir strain (relative risk 1.09; 95% CI 1.04 to 1.14) and LV stroke volume index (OR 1.04; 95% CI 1.01 to 1.07) were predictors of postoperative improvement in peak VO2.ConclusionsOne-third of patients with severe tricuspid regurgitation due to Ebstein anomaly had postoperative improvement in aerobic capacity, and atrial function indices were the best predictors of postoperative improvement in aerobic capacity. These data provide new insight into the haemodynamic determinants of exercise capacity and lay the foundation for further studies to determine whether postoperative improvement in aerobic capacity translates to improved long-term survival, and whether timing of tricuspid valve surgery based on these echocardiographic indices will improve long-term outcomes.

scholarly journals Partial PFO Closure for Persistent Hypoxemia in a Patient with Ebstein Anomaly

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
S. A. Zuberi ◽  
S. Liu ◽  
J. W. Tam ◽  
F. Hussain ◽  
D. Maguire ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Patent Foramen Ovale ◽  
Foramen Ovale ◽  
Atrial Septal Defect Closure ◽  
Ebstein Anomaly ◽  
Severe Tricuspid Regurgitation ◽  
Tricuspid Valve Surgery ◽  
Acute Decompensation ◽  
The Right

Ebstein anomaly is characterized by deformities of the anterior leaflet of the tricuspid valve and atrialization of the right ventricle. Patients with severe tricuspid regurgitation are recommended to have tricuspid valve surgery with concomitant atrial septal defect closure. A 73-year-old female with Ebstein anomaly presented with severe hypoxemia. Transthoracic echocardiography revealed severe tricuspid regurgitation and a patent foramen ovale with right-to-left shunting. Complete percutaneous patent foramen ovale closure led to acute decompensation; however, partial closure led to hemodynamic stability and improved oxygenation. In conclusion, similar patients with “patent foramen ovale dependency” from longstanding shunts may benefit from partial patent foramen ovale closure.

scholarly journals Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation

2019 ◽  
Vol 74 (24) ◽  
pp. 2998-3008 ◽  
Author(s):  
Maurizio Taramasso ◽  
Giovanni Benfari ◽  
Pieter van der Bijl ◽  
Hannes Alessandrini ◽  
Adrian Attinger-Toller ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Tricuspid Regurgitation ◽  
Severe Tricuspid Regurgitation

Isolated Severe Tricuspid Regurgitation

2021 ◽  
Vol 77 (18) ◽  
pp. 2350-2351
Author(s):  
Jinmiao Chen ◽  
Minzhi Lv ◽  
Kui Hu ◽  
Yang Ming ◽  
Lai Wei
Keyword(s):  
Tricuspid Regurgitation ◽  
Severe Tricuspid Regurgitation

scholarly journals Severe tricuspid regurgitation 14 years after diagnosis of “transient neonatal tricuspid regurgitation”

Heart ◽  
2001 ◽  
Vol 86 (1) ◽  
pp. 88-90
Author(s):  
D Boshoff ◽  
L Mertens ◽  
M Gewillig
Keyword(s):  
Tricuspid Regurgitation ◽  
Neonatal Period ◽  
Clinical Course ◽  
Subsequent Evolution ◽  
Severe Tricuspid Regurgitation ◽  
Echocardiographic Examination ◽  
Long Term Follow Up ◽  
Transient Tricuspid Regurgitation

A 14 year old girl presented with severe tricuspid regurgitation after she was diagnosed with “transient tricuspid regurgitation of the newborn”. In the neonatal period she had presented with severe tricuspid regurgitation without an obvious underlying anatomical cause. This spontaneously regressed during the first months of life. She was dismissed from follow up at the age of 5 years after complete normalisation of the clinical and echocardiographic examination. The subsequent evolution and management of the patient, as well as the possible pathogenesis responsible for the unusual clinical course, is discussed. This case stresses the importance of long term follow up of patients with transient tricuspid regurgitation.

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