Tricuspid valve myxoma in a patient with congestive heart failure

In 2010, an 82-year-old patient received a diagnosis of stage IV chronic obstructive pulmonary disease, ischemic dilated cardiomyopathy, severe secondary pulmonary hypertension, atrial fibrillation with slow ventricular response, and severe tricuspid regurgitation. In December 2011, he was hospitalized for exacerbation of chronic obstructive pulmonary disease. The patient received antibiotics via injections (for 2 weeks through a peripheral venous catheter). In February 2012, he returned to the hospital with congestive heart failure and vascular purpura skin lesions. The echocardiography examination revealed a rupture of cordage afferent to the septal tricuspid valve. Because blood cultures were sterile after 10 days and no vegetation was revealed, the Duke criteria were not fulfilled. In March 2012, the patient returned with congestive heart failure, fatigue, and anorexia. Echocardiography evaluation then revealed attached septal tricuspid valve vegetation. The Duke criteria were now satisfied. The patient received antibiotics at doses recommended for infective endocarditis, with a favorable outcome.

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Anomalous mitral arcade leading to congenital mitral insufficiency with an associated anomaly of the tricuspid valve

Cardiology in the Young ◽

10.1017/s1047951100007939 ◽

1992 ◽

Vol 2 (4) ◽

pp. 357-358 ◽

Cited By ~ 2

Author(s):

Jyoti V. Mandke ◽

Vikas R. Dharnidharka ◽

Vasundhara P. Sanzgiri

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Tricuspid Valve ◽

Acute Onset ◽

Mitral Insufficiency

SummaryA 21-day-old girl presented with congestive heart failure of acute onset and Doppler evidence of mitral regurgitation, which subsequently proved fatal. Necropsy revealed an anomalous arcade lesion of the mitral valve. The tendinous cords of the tricuspid valve were also abnormal, a finding, to the best of our knowledge, not reported before.

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Outcomes of tricuspid valve surgery in patients with functional tricuspid regurgitation

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa350 ◽

2020 ◽

Author(s):

Siddharth Pahwa ◽

Nishant Saran ◽

Alberto Pochettino ◽

Hartzell Schaff ◽

John Stulak ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Congestive Heart Failure ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Valve Surgery ◽

Late Mortality ◽

Functional Tricuspid Regurgitation ◽

Tricuspid Valve Surgery ◽

Independent Risk Factors

Abstract OBJECTIVES Functional tricuspid regurgitation (fTR) has been amenable to tricuspid valve repair (TVr), with fewer patients needing tricuspid valve replacement (TVR). We sought to review our experience of tricuspid valve surgery for fTR. METHODS A retrospective analysis of adult patients (≥18 years) who underwent primary tricuspid valve surgery for fTR (n = 926; mean age 68.6 ± 12.5 years; 67% females) from January 1993 through June 2018 was conducted. There were 767 (83%) patients who underwent TVr (ring annuloplasty, 67%; purse-string annuloplasty, 33%) and 159 (17%) underwent TVR (bioprosthetic valves, 87%; mechanical valves, 13%). The median follow-up was 8.2 years [95% confidence interval (CI) 7.2–8.9 years]. RESULTS A greater proportion of patients who underwent TVR had severe right ventricular dysfunction (P < 0.001), severe tricuspid regurgitation (P < 0.001) and congestive heart failure (P = 0.001) while the TVr cohort had a greater proportion with severe mitral valve (MV) regurgitation (P < 0.001) and concomitant cardiac procedures. Early mortality (TVR, 9% vs TVr, 3%; P = 0.004), renal failure (TVR, 10% vs TVr, 5%; P = 0.014) and hospital stay (TVR, 15 ± 15 days vs TVr, 12 ± 11 days; P < 0.001) were greater in TVR patients. The TVR cohort had worse survival [hazard ratio (HR) 1.57; 95% CI 1.23–1.99]. Multivariable analysis identified congestive heart failure (HR 1.37; 95% CI 1.10–1.72), renal failure (HR 1.79; 95% CI 1.14–2.82), previous MV surgery (HR 1.35; 95% CI 1.05–1.72) and TVR (HR 1.36; 95% CI 1.03–1.79) as independent risk factors for late mortality. CONCLUSIONS Tricuspid repair for fTR appears to have better early and late outcomes. Since previous MV surgery and TVR are identified as independent risk factors for late mortality, concomitant TVr at the time of index MV surgery may be considered. Early referral before the onset of advanced heart failure may improve outcomes.

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Predictors of Surgical Outcome in Isolated Tricuspid Valve Endocarditis: Single Center Experience of 60 Patients

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0037-1606386 ◽

2017 ◽

Vol 65 (08) ◽

pp. 634-638 ◽

Cited By ~ 4

Author(s):

Mahmoud Singer ◽

Tarek Mohsen ◽

Amr Roushdy ◽

Alsayed Akl ◽

Marwa Mashaal ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Pericardial Effusion ◽

Hospital Mortality ◽

Tricuspid Valve ◽

Surgical Outcome ◽

Significant Risk ◽

Pulmonary Embolization ◽

Preoperative Predictors ◽

Tricuspid Valve Endocarditis

Background Tricuspid valve (TV) endocarditis may be associated with serious complications, and 25% of patients require surgical intervention. However, indications and outcomes of surgery are not clearly identified. In this study, 60 patients are retrospectively reviewed to determine preoperative predictors of surgical outcome. Patients and Methods Sixty patients with isolated TV endocarditis who underwent surgery in the period between January 2012 and December 2016 are reviewed retrospectively from the medical records of Cairo University Hospitals. Forty-two (70%) patients were males, and 18 (30%) were females with a mean age of 29.3 ± 10.6 years. Eleven patients had an underlying cardiac lesion, and 27 patients were intravenous (IV)-drug addicts. Results TV repair could be done in nine (15%) patients, and the rest received TV replacement with biological valves. Twenty-four (40%) patients experienced postoperative complications. On multivariate analysis, a vegetation size >2.2 cm was a significant preoperative predictor for embolic complications and prolonged ventilation. In-hospital mortality occurred in 10 (16.67%) patients. Significant preoperative predictors of mortality were pulmonary embolization, congestive heart failure (HF), and the presence of pericardial effusion. During a mean follow-up period of 25 ± 12.6 months with echocardiography, two (4%) IV drug user patients developed recurrence of infection and needed reoperation. Conclusion Surgery for tricuspid valve endocarditis (TVE) can be performed with good early and mid-term results. A large size of vegetations >2.2 cm is a significant risk factor for embolic complications. Preoperative predictors of in-hospital mortality according to our study are pulmonary embolization, congestive heart failure, and pericardial effusion.

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Percutaneous Tricuspid Valve Implantation in a Fontan Patient With Congestive Heart Failure and Protein-Losing Enteropathy

Circulation Cardiovascular Interventions ◽

10.1161/circinterventions.110.958736 ◽

2011 ◽

Vol 4 (1) ◽

pp. 112-113 ◽

Cited By ~ 10

Author(s):

Bart Straver ◽

Lodewijk J. Wagenaar ◽

Nico A. Blom ◽

Barbara J.M. Mulder ◽

Berto J. Bouma ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Tricuspid Valve ◽

Fontan Patient ◽

Protein Losing Enteropathy ◽

Valve Implantation

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Tricuspid valve dysplasia in dogs

Vlaams Diergeneeskundig Tijdschrift ◽

10.21825/vdt.v87i1.16091 ◽

2018 ◽

Vol 87 (1) ◽

pp. 14-21 ◽

Cited By ~ 2

Author(s):

S. Favril ◽

B. J. G. Broeckx ◽

H. De Rooster ◽

P. Smets ◽

L. Peelman ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Tricuspid Valve ◽

Heart Diseases ◽

Doppler Imaging ◽

Exercise Intolerance ◽

Cardiac Cachexia ◽

Clinical Phase ◽

Asymptomatic Phase ◽

Surgical Valve Replacement

A general overview of tricuspid valve dysplasia in dogs is presented in this review. This congenital disease has been described in numerous large dog breeds but especially the Labrador retriever is predisposed. The condition is relatively uncommon, with a prevalence of approximately seven percent of all congenital heart diseases in dogs. The asymptomatic phase may last for several years and depends on the severity of the valve malformation. In the clinical phase, exercise intolerance, fatigue, anorexia, cardiac cachexia, dyspnea and signs of right-sided congestive heart failure can be present. Echocardiography including Doppler imaging is warranted to confirm the diagnosis. Curative treatment involves surgical valve replacement but is technically challenging and still in its experimental phase in dogs. As such, treatment in dogs involves the administration of supportive medication once the dogs develop symptoms of congestive heart failure and consists of diuretics, ace-inhibitors and positive inotropic drugs.

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