The Frequency of Tricuspid Stenosis with Particular Reference to Cardiac Surgery

In a series of 509 consecutive autopsied cases of rheumatic heart disease, there were 282 instances of severe stenosis of the mitral and/or aortic valves. An additional 17 (5.7 per cent) had an associated tricuspid stenosis which might be benefited by commissurotomy. Because this series is based on morphologic alterations without regard for the clinical criteria for the selection of patients for cardiac surgery, it is suggested that this group may be larger than is apparent from this figure. The unmasking of unrecognized tricuspid stenosis following mitral commissurotomy and improvement after subsequent tricuspid commissurotomy is noted. The diagnosis of tricuspid stenosis is no longer only a question of prognosis and of academic interest as an exercise in clinical diagnosis. Increased awareness of the frequency of tricuspid stenosis, careful clinical observation of patients with rheumatic heart disease, and the use of newer techniques such as cardiac catheterization to detect this lesion may permit surgical benefit for such patients.