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Tricuspid Valve Pathology

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Right Heart Pathology

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Abstract

Tricuspid valve pathology has increasingly become the focus of attention in recent years. Both primary and secondary disease processes involve the tricuspid valve. Depending on the underlying disease process the predominant hemodynamic lesion can be either tricuspid valve stenosis or regurgitation. Whereas tricuspid stenosis is uncommon, tricuspid regurgitation is frequently encountered and is most often secondary in nature. Patients with tricuspid valve disease are usually in an advanced stage of multivalvular heart disease and constitute a high-risk group. Recent improved understanding of the pathophysiology of tricuspid valve disease coupled with substantial advances in assessment and management have improved the outlook for patients with tricuspid valve pathology. This chapter provides an overview of tricuspid valve pathology focusing on pathophysiology, diagnosis, management and emerging transcatheter therapies.

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References

  1. Shah PM, Raney AA. Tricuspid valve disease. Curr Probl Cardiol. 2008;33:47–84.

    Article  PubMed  Google Scholar 

  2. Bruce CJ, Connolly HM. Right-sided valve disease deserves a little more respect. Circulation. 2009;119:2726–34.

    Article  PubMed  Google Scholar 

  3. Guenther T, Norbauer C, Mazzitelli D, Busch RB, Tassani-Prell P, Lange R. Tricuspid valve surgery: a thirty-year assessment of early and late outcome. J Cardiothorac Surg. 2008;34:402–9.

    Article  Google Scholar 

  4. Singh SK, Tang GHL, Maganti MD, Armstrong S, Williams WG, David TE, et al. Midterm outcomes of tricuspid valve repair versus replacement for organic tricuspid disease. Ann Thorac Surg. 2006;82:1735–41.

    Article  PubMed  Google Scholar 

  5. McCarthy PM, Bhudia SK, Rajeswaran J, Hoercher KJ, Lytle BW, Cosgrove DM, et al. Tricuspid valve repair: durability and risk factors for failure. J Thorac Cardiovasc Surg. 2004;127:674–85.

    Article  PubMed  Google Scholar 

  6. Shah PM. Tricuspid and pulmonary valve disease evaluation and management. Rev Esp Cardiol. 2010;63:1349–65.

    Article  PubMed  Google Scholar 

  7. Tei C, Pilgrim JP, Shah PM, Ormiston JA, Wong M. The tricuspid valve annulus: study of size and motion in normal subjects and in patients with tricuspid regurgitation. Circulation. 1982;6:665–71.

    Article  Google Scholar 

  8. Joudinaud TM, Flecher EM, Duran CM. Functional terminology for the tricuspid valve. J Heart Valve Dis. 2006;15:382–8.

    PubMed  Google Scholar 

  9. Waller BF, Moriarty AT, Eble JN, Davey DM, Hawley DA, Pless JE. Etiology of pure tricuspid regurgitation based on annular circumference and leaflet area: analysis of 45 necropsy patients with clinical and morphologic evidence of pure tricuspid regurgitation. J Am Coll Cardiol. 1986;7:1063–74.

    Article  PubMed  CAS  Google Scholar 

  10. Waller BF, Howard J, Fess S. Pathology of tricuspid valve stenosis and pure tricuspid regurgitation part III. Clin Cardiol. 1995;18:225–30.

    Article  PubMed  CAS  Google Scholar 

  11. Shiran A, Sagie A. Tricuspid regurgitation in mitral valve disease. J Am Coll Cardiol. 2009;53:401–8.

    Article  PubMed  Google Scholar 

  12. Adler DS. Non-functional tricuspid valve disease. Ann Cardiothorac Surg. 2017;6:204–13.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wooley CF, Fontana ME, Kilman JW, Ryan JM. Tricuspid stenosis: atrial systolic murmur, tricuspid opening snap, and right atrial pressure pulse. Am J Med. 1985;78:375–84.

    Article  PubMed  CAS  Google Scholar 

  14. Tei C, Shah PM, Tanaka H. Phonographic-echographic documentation of systolic honk in tricuspid prolapse. Am Heart J. 1982;103:294–5.

    Article  PubMed  CAS  Google Scholar 

  15. Rivera JM, Vandervoort PM, Vazquez de Prada JA, Mele D, Karson TH, Morehead A. Which physical factors determine tricuspid regurgitation jet area in the clinical setting? Am J Cardiol. 1993;72:1305–9.

    Article  PubMed  CAS  Google Scholar 

  16. Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. A report from the American Society of Echocardiography’s nomenclature and standards committee and the task force on valvular regurgitation. J Am Soc Echocardiogr. 2003;16:777–802.

    Article  PubMed  Google Scholar 

  17. Tei C, Shah PM, Cherian G, Trim PA, Wong M, Ormiston JA. Echocardiographic evaluation of normal and prolapsed tricuspid valve leaflets. Am J Cardiol. 1983;52:796–800.

    Article  PubMed  CAS  Google Scholar 

  18. Fuster V, O’Rourke RA, Poole-Wilson P. Tricuspid valve, pulmonary valve and multiple valve disease. Hurst’s The Heart. 2009;13:1745–56.

    Google Scholar 

  19. Dreyfus GD, Corbi PJ, Chan KM, Bahrami T. Secondary tricuspid regurgitation or dilatation: which should be criteria for surgical repair? Ann Thorac Surg. 2005;79:127–32.

    Article  PubMed  Google Scholar 

  20. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM 3rd, Thomas JD, ACC/AHA Task Force Members. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:2440–92.

    Article  PubMed  Google Scholar 

  21. Bernal JM, Pontón A, Diaz B, Llorca J, García I, Sarralde A, Diago C, Revuelta JM. Surgery for rheumatic tricuspid valve disease: a 30-year experience. J Thorac Cardiovasc Surg. 2008;136:476–81.

    Article  PubMed  Google Scholar 

  22. Raja SG, Dreyfus GD. Surgery for functional tricuspid regurgitation: current techniques, outcomes and emerging concepts. Expert Rev Cardiovasc Ther. 2009;7:73–84.

    Article  PubMed  Google Scholar 

  23. De Vega NG. Selective, adjustable and permanent annuloplasty. An original technic for the treatment of tricuspid insufficiency. Rev Esp Cardiol. 1972;25:555–6. [Spanish].

    PubMed  Google Scholar 

  24. Hata H, Fujita T, Shimahara Y, Sato S, Kobayashi J. Early and mid-term outcomes of aggressive tricuspid annuloplasty with the MC3 ring. J Heart Valve Dis. 2014;23:601–8.

    PubMed  Google Scholar 

  25. Alfieri O, De Bonis M, Lapenna E, Agricola E, Quarti A, Maisano F. The “clover technique” as a novel approach for correction of post-traumatic tricuspid regurgitation. J Thorac Cardiovasc Surg. 2003;126:75–9.

    Article  PubMed  CAS  Google Scholar 

  26. Lai YQ, Meng X, Bai T, Zhang C, Luo Y, Zhang ZG. Edge-to-edge tricuspid valve repair: an adjuvant technique for residual tricuspid regurgitation. Ann Thorac Surg. 2006;81:2179–82.

    Article  PubMed  Google Scholar 

  27. Kay JH, Maselli-Campagna G, Tsuji KK. Surgical treatment of tricuspid insufficiency. Ann Surg. 1965;162:53–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  28. Dreyfus GD, Raja SG, John Chan KM. Tricuspid leaflet augmentation to address severe tethering in functional tricuspid regurgitation. Eur J Cardiothorac Surg. 2008;34:908–10.

    Article  PubMed  Google Scholar 

  29. Tanaka M, Ohata T, Fukuda S, Kigawa I, Yamashita Y, Wanibuchi Y. Tricuspid valve supra-annular implantation in adult patients with Ebstein’s anomaly. Ann Thorac Surg. 2001;71:582–6.

    Article  PubMed  CAS  Google Scholar 

  30. Ratnatunga CP, Edwards MB, Dore CJ, Taylor KM. Tricuspid valve replacement: UK heart valve registry mid-term results comparing mechanical and biological prostheses. Ann Thorac Surg. 1998;66:1940–7.

    Article  PubMed  CAS  Google Scholar 

  31. Rizzoli G, Vendramin I, Nesseris G, Bottio T, Guglielmi C, Schiavon L. Biological or mechanical prostheses in tricuspid position? A meta-analysis of intra-institutional results. Ann Thorac Surg. 2004;77:1607–14.

    Article  PubMed  Google Scholar 

  32. Al-Najashi KS, Balint OH, Oechslin E, Williams WG, Silversides CK. Mid-term outcomes in adults with Ebstein anomaly and cavopulmonary shunts. Ann Thorac Surg. 2009;88:131–6.

    Article  PubMed  Google Scholar 

  33. Brown ML, Dearani JA, Danielson GK, Cetta F, Connolly HM, Warnes CA, et al. Functional status after operation for Ebstein anomaly. J Am Coll Cardiol. 2008;52(6):460–6.

    Article  PubMed  Google Scholar 

  34. Moller JE, Pellikka PA, Bernheim AM, Schaff HV, Rubin J, Connolly HM. Prognosis of carcinoid heart disease analysis of 200 cases over two decades. Circulation. 2005;112:3320–7.

    Article  PubMed  Google Scholar 

  35. Raja SG, Bhattacharyya S, Davar J, Dreyfus GD. Surgery for carcinoid heart disease: current outcomes, concerns and controversies. Futur Cardiol. 2010;6:647–55.

    Article  Google Scholar 

  36. Yee ES, Khonsari S. Right-sided infective endocarditis: valvuloplasty, valvectomy or replacement. J Cardiovasc Surg. 1989;30:744–8.

    CAS  Google Scholar 

  37. Konstantinov IE. Total resection and complete reconstruction of the tricuspid valve in acute infective endocarditis. J Thorac Cardiovasc Surg. 2008;136(2):531.

    Article  PubMed  Google Scholar 

  38. Veerbhadran SP, Pillai VV, Sasidharan B, Karunakaran J. Surgery for congenital tricuspid valve cleft: tricuspid valve repair with neochordae and annuloplasty. J Heart Valve Dis. 2015;24:525–7.

    PubMed  Google Scholar 

  39. Uehara K, Minakata K, Watanabe K, Sakaguchi H, Yamazaki K, Ikeda T, et al. Tricuspid valve repair for severe tricuspid regurgitation due to pacemaker leads. Asian Cardiovasc Thorac Ann. 2016;24:541–5.

    Article  PubMed  Google Scholar 

  40. Bouleti C, Juliard JM, Himbert D, Iung B, Brochet E, Urena M, et al. Tricuspid valve and percutaneous approach: no longer the forgotten valve! Arch Cardiovasc Dis. 2016;109:55–66.

    Article  PubMed  Google Scholar 

  41. Schofer J, Bijuklic K, Tiburtius C, Hansen L, Groothuis A, Hahn RT. First-in-human transcatheter tricuspid valve repair in a patient with severely regurgitant tricuspid valve. J Am Coll Cardiol. 2015;65:1190–5.

    Article  PubMed  Google Scholar 

  42. Latib A, Agricola E, Pozzoli A, Denti P, Taramasso M, Spagnolo P, et al. First-in-man implantation of a tricuspid annular remodeling device for functional tricuspid regurgitation. JACC Cardiovasc Interv. 2015;8:e211–4.

    Article  PubMed  Google Scholar 

  43. Ruiz CE, Kliger C, Perk G, Maisano F, Cabalka AK, Landzberg M, et al. Transcatheter therapies for the treatment of valvular and paravalvular regurgitation in acquired and congenital valvular heart disease. J Am Coll Cardiol. 2015;66:169–83.

    Article  PubMed  Google Scholar 

  44. Rogers T, Ratnayaka K, Sonmez M, Franson DN, Schenke WH, Mazal JR, Kocaturk O, Chen MY, Faranesh AZ, Lederman RJ. Transatrial intrapericardial tricuspid annuloplasty. JACC Cardiovasc Interv. 2015;8:483–91.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Cardiac Surgery, Harefield Hospital, Harefield, Middlesex, UK

    Shahzad G. Raja

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  1. Shahzad G. Raja
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Editors and Affiliations

  1. Department of Medicine, Titu Maiorescu University, Bucharest, Romania

    Silviu Ionel Dumitrescu

  2. Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    Ion C. Ţintoiu

  3. Department of Surgery, Chinese University of Hong Kong, Sha Tin, Hong Kong

    Malcolm John Underwood

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Raja, S.G. (2018). Tricuspid Valve Pathology. In: Dumitrescu, S., Ţintoiu, I., Underwood, M. (eds) Right Heart Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-73764-5_16

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  • DOI: https://doi.org/10.1007/978-3-319-73764-5_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-73763-8

  • Online ISBN: 978-3-319-73764-5

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