The importance of tricuspid valve structure and function in the surgical treatment of rheumatic mitral and aortic disease
A significant proportion of individuals with rheumatic disease have tricuspid valve involvement which may be clinically important and alter the medical or surgical approach to treatment. Therefore 50 patients with rheumatic left-sided valvular lesions who were referred for operative treatment were s...
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| Veröffentlicht in: | European heart journal 1992-03, Vol.13 (3), p.366-372 |
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| creator | FARID, L. DAYEM, M. KHAIRY A GUINDY, R. SHABETAI, R. DITTRICH, H. C. |
| description | A significant proportion of individuals with rheumatic disease have tricuspid valve involvement which may be clinically important and alter the medical or surgical approach to treatment. Therefore 50 patients with rheumatic left-sided valvular lesions who were referred for operative treatment were studied. Thirty patients had angiographically significant tricuspid regurgitation (group I) and 20 had a competent tricuspid valve (group II). Pre-operative cardiac assessment included Doppler echocardiography and contrast ventriculography. Patients with tricuspid regurgitation more commonly had mitral valve disease or combined mitral and aortic valve lesions, (P |
| doi_str_mv | 10.1093/oxfordjournals.eurheartj.a060176 |
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KHAIRY A ; GUINDY, R. ; SHABETAI, R. ; DITTRICH, H. C.</creator><creatorcontrib>FARID, L. ; DAYEM, M. KHAIRY A ; GUINDY, R. ; SHABETAI, R. ; DITTRICH, H. C.</creatorcontrib><description><![CDATA[A significant proportion of individuals with rheumatic disease have tricuspid valve involvement which may be clinically important and alter the medical or surgical approach to treatment. Therefore 50 patients with rheumatic left-sided valvular lesions who were referred for operative treatment were studied. Thirty patients had angiographically significant tricuspid regurgitation (group I) and 20 had a competent tricuspid valve (group II). Pre-operative cardiac assessment included Doppler echocardiography and contrast ventriculography. Patients with tricuspid regurgitation more commonly had mitral valve disease or combined mitral and aortic valve lesions, (P <0.001) and were more likely to have atrial fibrillation than those without tricuspid regurgitation (P <0.001). Pulmonary arterial systolic and mean right atrial pressures were higher in group I (both P <0.01). A close relationship was found between the angiographic and Doppler assessment of the degree of tricuspid regurgitation (P <0.01). Doppler-derived measurement of the right ventricular-right atrial systolic pressure difference correlated well with the systolic trans-tricuspid pressure difference measured at cardiac catheterization (y=0.7x+22, r=0.67, P<0.001) and the pulmonary arterial systolic pressure (y=0.8x+27, r=0.71, P<0.001). Rheumatic involvement of the tricuspid valve identified by pre-operative echocardiography was confirmed in five patients at surgery. Of the 13 patients with functional tricuspid regurgitation at operation, only two had been diagnosed as having organic disease by echocardiography. Furthermore, in all 18 cases where Doppler suggested grade 3 or 4+ tricuspid regurgitation, surgical repair or replacement of the valve was performed. Right ventricular ejection fraction <45% was associated with severe tricuspid regurgitation (grade 3 and 4+) while right ventricular ejection fraction >45% was associated with grade 1 and 2 + tricuspid regurgitation. These findings demonstrate that abnormalities of the tricuspid valve, whether functional or due to rheumatic involvement, are frequent in young individuals with left-sided rheumatic heart disease. The pathogenesis and severity of tricuspid disease is readily identified by Doppler echocardiography. The tricuspid valve should be carefully evaluated by Doppler echocardiography in patients being considered for surgical treatment of rheumatic valve disease, because the results can importantly influence the surgical approach.]]></description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/oxfordjournals.eurheartj.a060176</identifier><identifier>PMID: 1597224</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adolescent ; Adult ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Aortography ; Biological and medical sciences ; cardiac surgery ; Cardiology. Vascular system ; Child ; Doppler ; echocardiography ; Female ; Heart ; Heart Valve Diseases - diagnostic imaging ; Heart Valve Diseases - surgery ; Hemodynamics ; Humans ; Male ; Medical sciences ; Mitral Valve - diagnostic imaging ; Mitral Valve - surgery ; Radionuclide Ventriculography ; Rheumatic heart disease ; Rheumatic Heart Disease - diagnostic imaging ; Rheumatic Heart Disease - surgery ; tricuspid valve ; Tricuspid Valve - diagnostic imaging ; Tricuspid Valve - physiopathology ; Tricuspid Valve Insufficiency - diagnostic imaging ; Tricuspid Valve Insufficiency - physiopathology ; Ultrasonography ; Ventricular Function, Right</subject><ispartof>European heart journal, 1992-03, Vol.13 (3), p.366-372</ispartof><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-8a74e382b81a00e147be087facfd1f0a00095434e99891a1456e14323b3e98693</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4387937$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1597224$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FARID, L.</creatorcontrib><creatorcontrib>DAYEM, M. KHAIRY A</creatorcontrib><creatorcontrib>GUINDY, R.</creatorcontrib><creatorcontrib>SHABETAI, R.</creatorcontrib><creatorcontrib>DITTRICH, H. C.</creatorcontrib><title>The importance of tricuspid valve structure and function in the surgical treatment of rheumatic mitral and aortic disease</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description><![CDATA[A significant proportion of individuals with rheumatic disease have tricuspid valve involvement which may be clinically important and alter the medical or surgical approach to treatment. Therefore 50 patients with rheumatic left-sided valvular lesions who were referred for operative treatment were studied. Thirty patients had angiographically significant tricuspid regurgitation (group I) and 20 had a competent tricuspid valve (group II). Pre-operative cardiac assessment included Doppler echocardiography and contrast ventriculography. Patients with tricuspid regurgitation more commonly had mitral valve disease or combined mitral and aortic valve lesions, (P <0.001) and were more likely to have atrial fibrillation than those without tricuspid regurgitation (P <0.001). Pulmonary arterial systolic and mean right atrial pressures were higher in group I (both P <0.01). A close relationship was found between the angiographic and Doppler assessment of the degree of tricuspid regurgitation (P <0.01). Doppler-derived measurement of the right ventricular-right atrial systolic pressure difference correlated well with the systolic trans-tricuspid pressure difference measured at cardiac catheterization (y=0.7x+22, r=0.67, P<0.001) and the pulmonary arterial systolic pressure (y=0.8x+27, r=0.71, P<0.001). Rheumatic involvement of the tricuspid valve identified by pre-operative echocardiography was confirmed in five patients at surgery. Of the 13 patients with functional tricuspid regurgitation at operation, only two had been diagnosed as having organic disease by echocardiography. Furthermore, in all 18 cases where Doppler suggested grade 3 or 4+ tricuspid regurgitation, surgical repair or replacement of the valve was performed. Right ventricular ejection fraction <45% was associated with severe tricuspid regurgitation (grade 3 and 4+) while right ventricular ejection fraction >45% was associated with grade 1 and 2 + tricuspid regurgitation. These findings demonstrate that abnormalities of the tricuspid valve, whether functional or due to rheumatic involvement, are frequent in young individuals with left-sided rheumatic heart disease. The pathogenesis and severity of tricuspid disease is readily identified by Doppler echocardiography. The tricuspid valve should be carefully evaluated by Doppler echocardiography in patients being considered for surgical treatment of rheumatic valve disease, because the results can importantly influence the surgical approach.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Aortography</subject><subject>Biological and medical sciences</subject><subject>cardiac surgery</subject><subject>Cardiology. Vascular system</subject><subject>Child</subject><subject>Doppler</subject><subject>echocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Valve Diseases - diagnostic imaging</subject><subject>Heart Valve Diseases - surgery</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - surgery</subject><subject>Radionuclide Ventriculography</subject><subject>Rheumatic heart disease</subject><subject>Rheumatic Heart Disease - diagnostic imaging</subject><subject>Rheumatic Heart Disease - surgery</subject><subject>tricuspid valve</subject><subject>Tricuspid Valve - diagnostic imaging</subject><subject>Tricuspid Valve - physiopathology</subject><subject>Tricuspid Valve Insufficiency - diagnostic imaging</subject><subject>Tricuspid Valve Insufficiency - physiopathology</subject><subject>Ultrasonography</subject><subject>Ventricular Function, Right</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkEtvEzEQxy0EKmnhIyD5gBCXDfba68cNVBVaqYhLEBUXa-KdpQ7Z3eBH1X57HCUK4mRp_o8Z_wh5z9mSMys-zI_DHPvNXOIE27TEEu8RYt4sgSnGtXpGFrxr28Yq2T0nC8Zt1yhl7l6S85Q2jDGjuDojZ7yzum3lgjyt7pGGcTfHDJNHOg80x-BL2oWePsD2AWnKsfhcIlKYejqUyecwTzRMNNdsKvFX8LCtMYQ84pT3HfWsMkIOno4hx6ruo1CX1EkfEkLCV-TFUP-Ar4_vBfn--Wp1ed3cfvtyc_nptvHCitwY0BKFadeGA2PIpV4jM3oAP_R8YHXGbCeFRGuN5cBlp6pJtGIt0BplxQV5d-jdxflPwZTdGJLH7RYmnEtyurVK605V48eD0cc5pYiD28UwQnxynLk9ffc_fXei7470a8Wb466yHrH_V3DAXfW3Rx1SZTbEyjykk00Ko63Q1dYcbCFlfDzJEH87pYXu3PXdTyfM6sdXyaUz4i8jpKhP</recordid><startdate>19920301</startdate><enddate>19920301</enddate><creator>FARID, L.</creator><creator>DAYEM, M. KHAIRY A</creator><creator>GUINDY, R.</creator><creator>SHABETAI, R.</creator><creator>DITTRICH, H. C.</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19920301</creationdate><title>The importance of tricuspid valve structure and function in the surgical treatment of rheumatic mitral and aortic disease</title><author>FARID, L. ; DAYEM, M. KHAIRY A ; GUINDY, R. ; SHABETAI, R. ; DITTRICH, H. C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-8a74e382b81a00e147be087facfd1f0a00095434e99891a1456e14323b3e98693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Aortography</topic><topic>Biological and medical sciences</topic><topic>cardiac surgery</topic><topic>Cardiology. Vascular system</topic><topic>Child</topic><topic>Doppler</topic><topic>echocardiography</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Valve Diseases - diagnostic imaging</topic><topic>Heart Valve Diseases - surgery</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - surgery</topic><topic>Radionuclide Ventriculography</topic><topic>Rheumatic heart disease</topic><topic>Rheumatic Heart Disease - diagnostic imaging</topic><topic>Rheumatic Heart Disease - surgery</topic><topic>tricuspid valve</topic><topic>Tricuspid Valve - diagnostic imaging</topic><topic>Tricuspid Valve - physiopathology</topic><topic>Tricuspid Valve Insufficiency - diagnostic imaging</topic><topic>Tricuspid Valve Insufficiency - physiopathology</topic><topic>Ultrasonography</topic><topic>Ventricular Function, Right</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FARID, L.</creatorcontrib><creatorcontrib>DAYEM, M. KHAIRY A</creatorcontrib><creatorcontrib>GUINDY, R.</creatorcontrib><creatorcontrib>SHABETAI, R.</creatorcontrib><creatorcontrib>DITTRICH, H. C.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FARID, L.</au><au>DAYEM, M. KHAIRY A</au><au>GUINDY, R.</au><au>SHABETAI, R.</au><au>DITTRICH, H. C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The importance of tricuspid valve structure and function in the surgical treatment of rheumatic mitral and aortic disease</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>1992-03-01</date><risdate>1992</risdate><volume>13</volume><issue>3</issue><spage>366</spage><epage>372</epage><pages>366-372</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract><![CDATA[A significant proportion of individuals with rheumatic disease have tricuspid valve involvement which may be clinically important and alter the medical or surgical approach to treatment. Therefore 50 patients with rheumatic left-sided valvular lesions who were referred for operative treatment were studied. Thirty patients had angiographically significant tricuspid regurgitation (group I) and 20 had a competent tricuspid valve (group II). Pre-operative cardiac assessment included Doppler echocardiography and contrast ventriculography. Patients with tricuspid regurgitation more commonly had mitral valve disease or combined mitral and aortic valve lesions, (P <0.001) and were more likely to have atrial fibrillation than those without tricuspid regurgitation (P <0.001). Pulmonary arterial systolic and mean right atrial pressures were higher in group I (both P <0.01). A close relationship was found between the angiographic and Doppler assessment of the degree of tricuspid regurgitation (P <0.01). Doppler-derived measurement of the right ventricular-right atrial systolic pressure difference correlated well with the systolic trans-tricuspid pressure difference measured at cardiac catheterization (y=0.7x+22, r=0.67, P<0.001) and the pulmonary arterial systolic pressure (y=0.8x+27, r=0.71, P<0.001). Rheumatic involvement of the tricuspid valve identified by pre-operative echocardiography was confirmed in five patients at surgery. Of the 13 patients with functional tricuspid regurgitation at operation, only two had been diagnosed as having organic disease by echocardiography. Furthermore, in all 18 cases where Doppler suggested grade 3 or 4+ tricuspid regurgitation, surgical repair or replacement of the valve was performed. Right ventricular ejection fraction <45% was associated with severe tricuspid regurgitation (grade 3 and 4+) while right ventricular ejection fraction >45% was associated with grade 1 and 2 + tricuspid regurgitation. These findings demonstrate that abnormalities of the tricuspid valve, whether functional or due to rheumatic involvement, are frequent in young individuals with left-sided rheumatic heart disease. The pathogenesis and severity of tricuspid disease is readily identified by Doppler echocardiography. The tricuspid valve should be carefully evaluated by Doppler echocardiography in patients being considered for surgical treatment of rheumatic valve disease, because the results can importantly influence the surgical approach.]]></abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>1597224</pmid><doi>10.1093/oxfordjournals.eurheartj.a060176</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | European heart journal, 1992-03, Vol.13 (3), p.366-372 |
| issn | 0195-668X 1522-9645 |
| language | eng |
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| source | Oxford University Press Journals Digital Archive legacy; MEDLINE |
| subjects | Adolescent Adult Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortography Biological and medical sciences cardiac surgery Cardiology. Vascular system Child Doppler echocardiography Female Heart Heart Valve Diseases - diagnostic imaging Heart Valve Diseases - surgery Hemodynamics Humans Male Medical sciences Mitral Valve - diagnostic imaging Mitral Valve - surgery Radionuclide Ventriculography Rheumatic heart disease Rheumatic Heart Disease - diagnostic imaging Rheumatic Heart Disease - surgery tricuspid valve Tricuspid Valve - diagnostic imaging Tricuspid Valve - physiopathology Tricuspid Valve Insufficiency - diagnostic imaging Tricuspid Valve Insufficiency - physiopathology Ultrasonography Ventricular Function, Right |
| title | The importance of tricuspid valve structure and function in the surgical treatment of rheumatic mitral and aortic disease |
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