Tricuspid Valve

Answer 1

Preoperative workup for patients who are being considered for TV intervention includes coronary artery catheterization with assessment of right-sided hemodynamics in order to evaluate right ventricular function and pulmonary hypertension.

Answer 2

Class I indications include patients with:
1. Severe TR undergoing left-sided surgery,
2. primary severe TR without severe RV dysfunction
3. severe primary or secondary TS.

Answer 3

Class IIa indications include patients with moderate TR in the setting of left-sided surgery without tricuspid annular dilation (>40 mm by echocardiography).

Answer 4

Question 5

Findings indicative of hemodynamically significant tricuspid stenosis:

Answer 5

Answer 6

Medical treatment for TR consists of diuresis andtreatment of underlying causes of heart failure and pulmonary hypertension.

Question 7

Indications for Surgery

Primary TR

Answer 7

1. In severe primary TR with symptoms of right heart failure, isolated tricuspid valve surgery can improve symptoms and reduce hospitalizations (Class 2a).
2. In asymptomatic patients with severeprimary TR, tricuspid valve surgery may be considered if RV dilation or dysfunction develop (Class2b).

Question 8

Indications for Surgery

Secondary tricuspid regurgitation ( Class 1 indications)

Answer 8

With respect to secondary TR, patients undergoing left-sided valve surgery should beconsidered for concomitant tricuspid valve surgery if the TR is severe (Class 1).

Question 9

Indications for Surgery

Secondary tricuspid regurgitation (Class 2 indications)