Tricuspid Valve Regurgitation Associated with Rheumatic Left Heart Valve Disease: 1002 Cases in one Single-Center Study
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Background: Right-sided valve abnormalities are less common than their left-sided counterparts. Furthermore, whilst organic rheumatic involvement of the tricuspid valve is not uncommon, it receives less attention than left-sided heart valves. An evidence-based systematic overview was carried out to assess the epidemiology, diagnosis and management of organic rheumatic tricuspid valve disease (RTVD) over the past half century.
Methods: This retrospective study was included 1002 of patients hospitalized in our center for severe rheumatic heart disease and they were collected over a period of 18 years (1994-2012). The clinical characteristics, data from different investigations, the indications, means and methods of treatment were analyzed.
Results:
Patients’ mean age was 42,3 +/- 11,5 years, female/male ratio was 1:1,26. RTVD was detected in 319 patients (39%). We noted 549 cases of mitral valve disease, 150 of aortic valve disease and 303 cases of both mitral and aortic valve disease.
About 40% had significant tricuspid regurgitation (≥ grade 2/4). 304 underwent tricuspid valve surgery (293 annuloplasty versus only 11 prosthetic replacements). Intra-hospital mortality was 7,4%. Post-operative echocardiography showed satisfactory results in all patients.
Conclusion: Functional tricuspid regurgitation is common among patients with rheumatic heart disease. It is frequently associated with mitral valve disease. Significant tricuspid valve regurgitation worsens the natural history of rheumatic valvulopathy and it should be managed uncompromisingly.
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