Tricuspid regurgitation surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
In most cases, surgery is not indicated since the root problem lies with a dilated or damaged right ventricle. Medical therapy with diuretics is the mainstay of treatment. Unfortunately, this can lead to volume depletion and decreased cardiac output. Indeed, one must often accept a certain degree of symptomatic tricuspid insufficiency in order to prevent a decrease in cardiac output. Treatment with medicines to reduce cardiac afterload may also be of benefit but a similar risk of depressed cardiac output applies.
2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease - Tricuspid Valve Replacement in Triscupid Regurgitation (DO NOT EDIT) [1]
| Class I |
| "1. Tricuspid valve repair is beneficial for severe TR in patients with mitral valve disease requiring mitral valve surgery. (Level B)" |
| Class III |
| "1. Tricuspid valve replacement or annuloplasty is not indicated in asymptomatic patients with TR whose pulmonary artery systolic pressure is less than 60 mm Hg in the presence of a normal mitral valve. (Level C)" |
| "2. Tricuspid valve replacement or annuloplasty is not indicated in patients with mild primary TR. (Level C)" |
| Class IIa |
| "1. Tricuspid valve replacement or annuloplasty is reasonable for severe primary TR when symptomatic. (Level C)" |
| "2. Tricuspid valve replacement is reasonable for severe TR secondary to diseased/abnormal tricuspid valve leaflets not amenable to annuloplasty or repair. (Level C)" |
| Class IIb |
| "1. Tricuspid valve replacement or annuloplasty is reasonable for severe primary TR when symptomatic. (Level C)" |
Sources
- 2008 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [1]
References
- ↑ 1.0 1.1 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
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