Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 130
Filter
Add more filters

Publication year range
1.
Cardiol Young ; 28(4): 608-610, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29316993

ABSTRACT

Ebstein's anomaly is a rare CHD that is characterised by caudal displacement of the functional tricuspid annulus and a dysfunctional tricuspid valve owing to a failure of proper leaflet coaptation. We present a balanced variant of Ebstein's anomaly, in which the overgrowth of the septal leaflet had allowed proper coaptation of the tricuspid leaflets, thus preserving the valve function.


Subject(s)
Ebstein Anomaly/diagnosis , Echocardiography/methods , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve/diagnostic imaging , Adolescent , Ebstein Anomaly/physiopathology , Humans , Male , Tricuspid Valve Insufficiency/diagnosis , Tricuspid Valve Insufficiency/physiopathology
2.
Cardiol Young ; 27(7): 1419-1422, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28460654

ABSTRACT

Neonatal cardiac lupus is a rare, passively acquired autoimmune disease. We report a case of in utero myocarditis, confirmed postnatally, with papillary muscle rupture and severe tricuspid regurgitation after birth in the absence of conduction disturbances. Tricuspid repair was successfully performed with polytetrafluoroethylene neochordae. In this article, we discuss the pathophysiology, medical and surgical management, and implications at follow-up in this unique scenario.


Subject(s)
Lupus Erythematosus, Systemic/congenital , Papillary Muscles/physiopathology , Polytetrafluoroethylene/therapeutic use , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve/physiopathology , Echocardiography, Doppler, Color , Humans , Infant, Newborn , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/physiopathology , Male , Myocarditis/congenital , Rupture, Spontaneous , Tricuspid Valve Insufficiency/congenital
3.
Cardiol Young ; 27(3): 597-599, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27680744

ABSTRACT

There are a few reports of successful replacement of the left-sided systemic tricuspid valve with a mechanical valve in small infants with congenitally corrected transposition of the great arteries having Ebstein's anomaly. Tricuspid valve replacement is the preferred option when pulmonary artery banding, performed as a prelude to performing the double-switch operation, is not feasible because of severe heart failure caused by tricuspid regurgitation.


Subject(s)
Abnormalities, Multiple , Arterial Switch Operation/methods , Heart Valve Prosthesis Implantation/methods , Transposition of Great Vessels/surgery , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve/surgery , Humans , Infant , Male , Radiography, Thoracic , Transposition of Great Vessels/diagnosis , Tricuspid Valve/abnormalities , Tricuspid Valve/diagnostic imaging , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/diagnosis
4.
Echocardiography ; 33(3): 479-83, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26660590

ABSTRACT

Duplication of an atrioventricular valve is a rare congenital anomaly that usually involves the mitral rather than the tricuspid valve (TV). Isolated appearances of a double-orifice TV (DOTV) are extremely rare and in most cases are associated with other congenital anomalies. We report a rare case of an HIV-seropositive male with a DOTV, divided right atrium and Wolff-Parkinson-White syndrome admitted to our hospital with palpitations and dyspnea. After medical therapy, the patient's symptoms were alleviated. We summarized the characteristics of the DOTV and reviewed the literature.


Subject(s)
Echocardiography/methods , Tricuspid Valve Insufficiency/diagnostic imaging , Tricuspid Valve Insufficiency/etiology , Tricuspid Valve/abnormalities , Tricuspid Valve/diagnostic imaging , Adult , Diagnosis, Differential , Humans , Male , Tricuspid Valve Insufficiency/congenital
5.
J Perinat Med ; 43(5): 597-603, 2015 Sep.
Article in English | MEDLINE | ID: mdl-24799402

ABSTRACT

BACKGROUND: Tricuspid regurgitation (TR) is a common sonographic finding during the fetal life. It has been reported in 7% of normal fetuses. It may be associated with aneuploidy and with both cardiac and extracardiac defects. OBJECTIVES: In this study, we have looked at the characteristics of fetuses with and without TR at 11+0 to 13+6 weeks' gestation. Groups were compared with respect to the following variables: prevalence of chromosomal defects; other markers of aneuploidy; fetal cardiac; and extracardiac anomalies. METHODS: The study group included women, who underwent an ultrasound examination at 11-13+6 weeks' gestation between 2009 and 2012. The inclusion criteria were singleton pregnancies with crown-rump length measurements of 45-84 mm where the pregnancy outcome was known. RESULTS: Some 1075 patients met our inclusion criteria including 979 fetuses without TR and 96 with TR. There were 72 cases of aneuploidy diagnosed (6.7%). Isolated TR was found in 53 euploid fetuses (5.2%). All of the TR(+) aneuploid fetuses (n=40) had additional ultrasound markers present. Extracardiac anatomy showed a higher prevalence of abnormalities in the group of TR positives (12.5%) vs. TR negatives (1.6%). Abnormal cardiac findings were more frequent in the TR-positive group independently of chromosomal status and were found in 18.8% of fetuses with TR and in 1.9% with a normal tricuspid flow. CONCLUSIONS: TR in combination with other markers is the strongest predictor for aneuploidy. TR, as an isolated parameter, is a poor screening tool both for all and for each individual chromosomal abnormality and congenital cardiac defects.


Subject(s)
Congenital Abnormalities/diagnostic imaging , Fetal Heart/diagnostic imaging , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/diagnostic imaging , Adult , Aneuploidy , Chromosome Aberrations , Crown-Rump Length , Female , Heart Defects, Congenital/complications , Heart Defects, Congenital/diagnostic imaging , Humans , Nuchal Translucency Measurement , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, First , Tricuspid Valve Insufficiency/complications , Ultrasonography, Prenatal
6.
J Card Surg ; 30(5): 421-3, 2015 May.
Article in English | MEDLINE | ID: mdl-25472661

ABSTRACT

In congenital non-Ebstein anomalies of the tricuspid valve, the septal leaflet is often involved and tethered. We describe a standardized approach to address septal leaflet tethering by concomitant augmentation of the anterior and posterior leaflets.


Subject(s)
Cardiac Valve Annuloplasty/methods , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve/abnormalities , Adolescent , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Treatment Outcome , Tricuspid Valve/surgery , Tricuspid Valve Insufficiency/congenital , Young Adult
7.
Heart Lung Circ ; 24(10): 996-1001, 2015 Oct.
Article in English | MEDLINE | ID: mdl-25911143

ABSTRACT

BACKGROUND: Ebstein's anomaly (EA) occurs in about one to five per 200 000 live births. Long-term follow-up data of adults with EA is scarce due to the relatively low frequency of the disease and the variation of its anatomic and haemodynamic severity. METHODS: Since 1995, in our adult congenital heart disease (ACHD) centre, we have practised a uniform approach to management of adults with EA, with surgery reserved for those with refractory arrhythmia (failed medical and/or catheter-based treatment) or worsening symptoms of breathlessness. A retrospective review of medical records of all such patients with EA and normal cardiac connections was performed. RESULTS: Fifty-one EA patients (17 males) were identified. Mean age at diagnosis was 21+/-21 years and mean follow-up time at our centre was 21±14 years. During this time, 18 patients (35%) had documented supraventricular arrhythmia. Sixteen patients (30%) underwent ablation therapy with long-term relief from arrhythmia in nine (56%). Nine patients (18%) underwent tricuspid valve (TV) surgery (four repair and five replacement), with seven patients having undergone a tricuspid valve surgery prior to referral to our unit. Three patients died, one of cardiogenic shock after redo surgery (58 years), one of progressive heart failure (45 years) and one with malignancy. Overall survival was 100% to age 40 years, 95% to age 50 years and 81% to age 60 years. CONCLUSIONS: Ebstein's Anomaly in adulthood often has severe morphological abnormalities but is compatible with good medium-term survival, with a generally symptom driven approach to the indications for interventions.


Subject(s)
Arrhythmias, Cardiac/etiology , Ebstein Anomaly/complications , Tricuspid Valve Insufficiency/etiology , Tricuspid Valve/surgery , Adolescent , Adult , Aged , Arrhythmias, Cardiac/drug therapy , Arrhythmias, Cardiac/surgery , Catheter Ablation , Child , Child, Preschool , Ebstein Anomaly/diagnosis , Ebstein Anomaly/mortality , Echocardiography , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Middle Aged , Retrospective Studies , Survival Rate , Tricuspid Valve/abnormalities , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/surgery , Young Adult
8.
Can Vet J ; 54(12): 1164-6, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24293678

ABSTRACT

A 6-month-old domestic shorthair cat was referred for evaluation of sudden lethargy and tachypnea following ovariohysterectomy. Upon failure of improvement with supportive care, a cardiologist identified congenital tricuspid dysplasia with signs of heart failure. Furosemide, enalapril, and pimobendan were used to reduce clinical signs and improve length and quality of life.


Usage de pimobendane lors d'une insuffisance cardiaque féline congénitale. Un chat commun domestique âgé de 6 mois a été recommandé pour l'évaluation d'un abattement et d'une tachypnée d'apparition soudaine après l'ovariohystérectomie. En absence d'amélioration avec des soins de soutien, un cardiologue a identifié une dysplasie tricuspidienne congénitale avec des signes d'insuffisance cardiaque. Le furosémide, l'enalapril et le pimobendane ont été utilisés pour atténuer les signes cliniques et améliorer la durée et la qualité de vie.(Traduit par Isabelle Vallières).


Subject(s)
Cardiotonic Agents/therapeutic use , Cat Diseases/drug therapy , Heart Failure/veterinary , Pyridazines/therapeutic use , Animals , Cat Diseases/congenital , Cat Diseases/diagnosis , Cats , Female , Heart Failure/congenital , Heart Failure/diagnosis , Heart Failure/drug therapy , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/veterinary
10.
Z Geburtshilfe Neonatol ; 216(4): 157-61, 2012 Aug.
Article in German | MEDLINE | ID: mdl-22926815

ABSTRACT

The present article summarises current knowledge on the risk of fetal cardiac malformations in fetuses with increased nuchal translucency (NT), abnormal ductus venosus blood flow pattern and tricuspid regurgitation. The risk of congenital heart disease (CHD) increases with increasing NT. However, nuchal translucency screening is only modestly efficient in the detection of congenital heart disease in low-risk pregnancies. If the nuchal translucency is normal, abnormal ductus venosus blood flow and tricuspid regurgitation show low sensitivities as single screening parameters. The combination of all 3 markers might increase the detection rates. Fetal echocardiography at 20 weeks of gestation is recommended in foetuses with an NT ≥95th percentile, as the incidence of CHD increases 2.5-fold. When the NT measurement is ≥99th percentile, the risk of CHD increases 10-fold. In this high-risk group and in fetuses with tricuspid regurgitation and/or an abnormal DV flow pattern along with an increased NT, first or early second trimester echocardiography performed by experts is warranted. The early examination of the fetal heart should be completed by a detailed echocardiogram at around 20 weeks of gestation.


Subject(s)
Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/epidemiology , Neonatal Screening/methods , Nuchal Translucency Measurement/statistics & numerical data , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/epidemiology , Veins/embryology , Blood Flow Velocity , Comorbidity , Female , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Trimester, First , Prevalence , Regional Blood Flow , Risk Factors , Veins/diagnostic imaging
11.
Cardiol Young ; 21(2): 121-9, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21205419

ABSTRACT

BACKGROUND AND AIM: Congenital tricuspid regurgitation is an extremely rare condition. The morphologic heterogeneity makes it difficult to derive any conclusions regarding the best strategy for management of this condition. METHODS: We analysed the published literature on "congenital tricuspid regurgitation" using MEDLINE. In addition, the reference sections of all relevant articles were searched to identify additional cases. Studies published till June 2009 are included. RESULTS: As far as we could establish, there were 123 cases of congenital tricuspid regurgitation. Of these, 63 were documented during surgery, 38 during autopsy, and 22 were diagnosed by echocardiography or cardiac catheterisation. The mean age was 22.57 years, with a standard deviation of 23.42 years, and the age ranged from 1 day to 80 years, with a median of 16 years. There was a male predominance, with a male-to-female ratio of approximately 3:2. CONCLUSION: Congenital tricuspid regurgitation is an uncommon clinical entity with wide anatomical variations. The severity of disease dictates the presentation in infancy, childhood, or adulthood. Tricuspid valve repair is the ideal treatment whenever feasible, especially in children. We propose a new classification for congenital tricuspid regurgitation, which not only includes the anatomical variations, but can also help the surgeon in deciding on the best strategy for management.


Subject(s)
Tricuspid Valve Insufficiency , Tricuspid Valve/abnormalities , Humans , Prevalence , Tricuspid Valve Insufficiency/classification , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/epidemiology , United States/epidemiology
12.
Ultrasound Obstet Gynecol ; 35(3): 297-301, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20069683

ABSTRACT

OBJECTIVE: To describe the prevalence of abnormal umbilical vein (UV) anatomy in fetuses with Down syndrome. METHODS: This was a retrospective survey covering a 24-month period of fetuses with a genetic diagnosis of Down syndrome following a routine early second-trimester (12-16-week) detailed fetal anomaly scan at a single academic tertiary referral center. In our unit this exam includes fetal umbilicoportal venous system evaluation. RESULTS: During the study period, 37 fetuses were diagnosed with Down syndrome and had a detailed early anatomy scan. In four (11%) the detailed early anomaly scan revealed that the UV was connected to the hepatic portion of the inferior vena cava (IVC) at a position lower than its usual site. Their average gestational age at diagnosis was 13 + 6 (range, 11 + 6 to 15 + 2) weeks. Three of the four fetuses had a nuchal translucency thickness of 3-4 mm. In one fetus there was an additional finding of significant tricuspid regurgitation and the one with normal nuchal translucency thickness had an atrioventricular septal defect (atrioventricular canal) and umbilical cord hernia. During the same period three of 2500 (0.12%) fetuses with normal karyotype demonstrated similar anomalous insertion of the UV into the IVC, creating a portocaval shunt which had normal ductus venosus-like Doppler flow in all three cases. The odds ratio for abnormal umbilicoportal venous system in fetuses with Down syndrome compared with the normal population was 107.4 (95% CI, 19.2-637.1). CONCLUSIONS: Fetuses with Down syndrome demonstrate an increased prevalence of abnormal connection of the UV to the IVC.


Subject(s)
Down Syndrome/diagnostic imaging , Fetal Diseases/diagnostic imaging , Umbilical Veins/diagnostic imaging , Adult , Blood Flow Velocity/physiology , Down Syndrome/embryology , Down Syndrome/physiopathology , Female , Fetal Diseases/physiopathology , Humans , Nuchal Translucency Measurement/methods , Portal Vein/abnormalities , Portal Vein/diagnostic imaging , Pregnancy , Pregnancy Trimester, Second , Retrospective Studies , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/diagnostic imaging , Ultrasonography, Prenatal/methods , Umbilical Veins/abnormalities , Umbilical Veins/physiopathology
14.
J Card Surg ; 25(6): 737-9, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20880079

ABSTRACT

Isolated congenital tricuspid regurgitation without downward displacement of the leaflet is uncommon in adults, and repair of such valves often requires a procedure that is more complex than simple tricuspid annuloplasty. We describe a technique of tricuspid valvoplasty using the neo-papillary loop technique to reconstruct multiple artificial chords for isolated congenital tricuspid regurgitation associated with a dysplastic anterior leaflet with agenesis of the chordae tendineae and a hypoplastic anterior papillary muscle. This technique provides a simple and valuable option for the repair of dysplastic valves lacking chordae, even those with a hypoplastic papillary muscle.


Subject(s)
Cardiac Valve Annuloplasty/methods , Chordae Tendineae/abnormalities , Chordae Tendineae/surgery , Papillary Muscles/abnormalities , Papillary Muscles/surgery , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve/abnormalities , Tricuspid Valve/surgery , Adult , Cardiac Surgical Procedures , Female , Humans , Plastic Surgery Procedures , Treatment Outcome
15.
J Card Surg ; 24(6): 727-31, 2009.
Article in English | MEDLINE | ID: mdl-19732217

ABSTRACT

OBJECTIVE: Tricuspid regurgitation is often associated in patients with congenital heart disease. Significant morbidity and mortality are related to tricuspid valve replacement. Tricuspid valve plasty is still a preferred choice. This report deals with our surgical experience in using the edge-to-edge valve plasty technique to correct severe tricuspid regurgitation in patients with congenital heart disease. METHODS: From December 2002 to August 2007, severe tricuspid regurgitation was corrected with a flexible band annuloplasty and edge-to-edge valve plasty technique in nine patients with congenital heart disease. The age ranged from 7 to 62 years (average 24.4 years). Congenital cardiac anomalies included atrioventricular canal in five cases, secundum atrial septal defect in three cases, and cor triatriatum in one case. RESULTS: No hospital death or postoperative morbidity occurred. No or trivial tricuspid regurgitation was present in six cases and mild tricuspid regurgitation in three cases at discharge. The follow-up ranged from 12 months to 70 months (average 39.3 months). No tricuspid stenosis was found. No to mild tricuspid regurgitation was present in eight cases, and moderate tricuspid regurgitation in one case at the latest follow-up. CONCLUSIONS: Edge-to-edge valve plasty is an easy, effective, and acceptable additional procedure to correct severe tricuspid regurgitation in patients with congenital heart disease.


Subject(s)
Heart Defects, Congenital/surgery , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve/surgery , Adolescent , Adult , Aged , Child , Female , Follow-Up Studies , Humans , Male , Middle Aged , Tricuspid Valve/abnormalities , Young Adult
16.
Cardiovasc Pathol ; 17(3): 166-71, 2008.
Article in English | MEDLINE | ID: mdl-18402795

ABSTRACT

BACKGROUND: Ebstein's anomaly has been described extensively in autopsy material. However, there have been no large surgical pathology series of this malformation. OBJECTIVE: To review clinical and surgical pathologic features of a large number of cases of Ebstein's anomaly from a single institution. METHODS: Review of medical histories, surgical reports, and surgical pathology reports at the Mayo Clinic (2000-2005). RESULTS: Among 104 patients, the mean age was 31 years (2 months-79 years), and 57% were female. Common ECG abnormalities included right bundle branch block (58%), first-degree heart block (31%), preexcitation (18%), and nonspecific intraventricular conduction delay/block (15%). Moreover, 74% had inter-atrial communication, 13% mitral valve prolapse, and 5% bicuspid aortic valve. Clinically, all had tricuspid regurgitation (severe in 74%), and 17% of anterior leaflets were fenestrated. No tricuspid valve was calcified. Surgically, tricuspid tissue was removed during replacement in 99% and repair in 1%. The anterior tricuspid leaflet was resected in 98%, and its length was 0.81-9.3 cm/m2 body surface area (mean, 3.3). Characteristically, leaflets were large and had irregular shapes and numerous short cordal or direct myocardial insertions. One tricuspid valve had two papillary fibroelastomas. None had clinical or pathologic evidence of active or healed endocarditis. CONCLUSIONS: Among patients with Ebstein's malformation, tricuspid valve tissue almost exclusively was removed during valve replacement and represented the anterior leaflet. Valve tissue was generally large, irregularly shaped, and associated with insertion of short cords or myocardial stumps. Interestingly, although appreciably deformed, Ebstein valves were not associated with infective endocarditis.


Subject(s)
Ebstein Anomaly/pathology , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve/abnormalities , Adolescent , Adult , Aged , Child , Child, Preschool , Ebstein Anomaly/complications , Ebstein Anomaly/physiopathology , Electrocardiography , Female , Heart Block/congenital , Heart Valve Prosthesis Implantation , Humans , Infant , Male , Middle Aged , Tricuspid Valve/surgery , Tricuspid Valve Insufficiency/physiopathology , Tricuspid Valve Insufficiency/surgery
17.
World J Pediatr Congenit Heart Surg ; 8(6): 740-742, 2017 11.
Article in English | MEDLINE | ID: mdl-29187115

ABSTRACT

Tricuspid regurgitation (TR) in infancy poses a surgical challenge. Both two- and three-dimensional echocardiography (3DE) can provide detailed information about the mechanism(s) of valve failure and insights into valve adaptation during follow-up. We report two patients who underwent tricuspid valve repair using Gore-Tex neochordae, repairs which were facilitated by and assessed with 3DE. Both infants had less than mild residual TR and no valve tethering at hospital discharge. Furthermore, follow-up 3DEs have helped to confirm valve competence, lack of tethering, and growth of the valve and valve apparatus.


Subject(s)
Cardiac Surgical Procedures/methods , Echocardiography, Three-Dimensional/methods , Polytetrafluoroethylene , Prostheses and Implants , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve/surgery , Chordae Tendineae , Humans , Infant , Prosthesis Design , Tricuspid Valve/abnormalities , Tricuspid Valve/diagnostic imaging , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/diagnosis
18.
Can J Cardiol ; 32(12): 1500-1506, 2016 12.
Article in English | MEDLINE | ID: mdl-27476984

ABSTRACT

BACKGROUND: Ebstein anomaly (EA) and tricuspid valve dysplasia (TVD) are rare anomalies and data on outcomes after a fetal or neonatal EA/TVD diagnosis are conflicting. METHODS: To examine the outcome and identify markers predictive of mortality, we reviewed our single-centre experience from 2000-2014. Variables were analyzed separately for cases diagnosed in utero without pregnancy termination and for all live-born patients. RESULTS: Of 47 fetal cases, 8 (17%) died in utero and 10 (21%) as neonates. Independent predictors associated with fetal demise included severe tricuspid regurgitation with a Doppler gradient < 40 mm Hg (odds ratio, 1.22 per mm Hg deduction; P = 0.003) and pulmonary regurgitation (odds ratio, 11.4; P = 0.03) at the baseline examination. A novel prognostic score (range, 0-10) combining the severity of 5 echocardiographic findings was independently associated with overall mortality (hazard ratio [HR], 1.39 per point increase; P = 0.01). Survival rates of 66 live births at 1 month, 1 year, and 5 years were 86%, 82%, and 80% respectively, and 75%, 60%, and 55% remained free from surgery at the same points in time. Factors associated with postnatal death in multivariate analysis included a younger gestational age at birth (HR per week, 1.59; P < 0.001), tricuspid annulus diameter (HR per z-score increase, 1.76; P = 0.004), and no pulmonary forward flow (HR, 4.63; P = 0.03). CONCLUSIONS: Our experience with fetal and neonatal EA/TVD shows better survival rates than previously reported. Mortality after a fetal diagnosis was significantly associated with hemodynamic changes indicative of a circular shunt, including pulmonary and tricuspid regurgitation severe enough to cause diastolic umbilical arterial flow reversal.


Subject(s)
Ebstein Anomaly , Echocardiography, Doppler/methods , Tricuspid Valve Insufficiency , Tricuspid Valve , Canada/epidemiology , Ebstein Anomaly/diagnosis , Ebstein Anomaly/mortality , Ebstein Anomaly/physiopathology , Female , Gestational Age , Humans , Infant , Infant, Newborn , Male , Perinatal Mortality , Predictive Value of Tests , Pregnancy , Prognosis , Retrospective Studies , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/physiopathology , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/diagnosis , Tricuspid Valve Insufficiency/mortality , Tricuspid Valve Insufficiency/physiopathology , Ultrasonography, Prenatal/methods
19.
J Am Coll Cardiol ; 13(3): 700-5, 1989 Mar 01.
Article in English | MEDLINE | ID: mdl-2918176

ABSTRACT

Doppler echocardiograms of the tricuspid and mitral valves were recorded along with the electrocardiogram and respiration in 22 normal full-term neonates. A computer-interfaced digitizer pad was utilized to measure the following: peak E and A velocities (cm/s); E and A areas (the components of the total velocity-time integral in the early passive period of ventricular filling [E] and the late active period of atrial emptying [A], respectively) and the 1/3 area fraction (or the proportion of filling in the first 1/3 of diastole). All of the variables of right (tricuspid) versus left (mitral) ventricular filling were significantly different on the 1st day of life. Respective values were peak E velocity (cm/s) 44.6 +/- 10.0 (tricuspid) versus 53.2 +/- 9.3 (mitral), p less than 0.01; peak E/A ratio 0.84 +/- 0.14 versus 1.15 +/- 0.17, p less than 0.0001; E/total area 0.58 +/- 0.07 versus 0.63 +/- 0.05, p less than 0.005; E/A area ratio 1.05 +/- 0.23 versus 1.63 +/- 0.40, p less than 0.0001; 1/3 area fraction 0.31 +/- 0.04 versus 0.41 +/- 0.04, p less than 0.0001; peak A velocity (cm/s) 53.0 +/- 8.4 versus 47.6 +/- 5.8, p less than 0.05 and A/total area 0.57 +/- 0.09 versus 0.41 +/- 0.09, p less than 0.001; the mean heart rate (beats/min) was not significantly different: 121 +/- 8 versus 120 +/- 7. Most of the variables remained significantly different on the 2nd day of life, but the level of significance was the same or less for all measurements.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Echocardiography, Doppler , Heart/physiology , Infant, Newborn/physiology , Cesarean Section , Diastole , Ductus Arteriosus, Patent/physiopathology , Electrocardiography , Humans , Mitral Valve/physiology , Reference Values , Respiration , Tricuspid Valve/physiology , Tricuspid Valve Insufficiency/congenital , Tricuspid Valve Insufficiency/physiopathology
20.
Circ Cardiovasc Interv ; 8(4)2015 Apr.
Article in English | MEDLINE | ID: mdl-25873731

ABSTRACT

BACKGROUND: Severe tricuspid valve (TV) dysfunction may lead to surgical TV replacement with a biological valve prosthesis in patients with congenital heart disease. To expand the lifetime of this valve and reduce the number of surgeries, percutaneous TV implantation (PTVI) may be an effective alternative to repeated surgery. We report on our 2-center experience with PTVI. METHODS AND RESULTS: Between 2008 and 2014, 17 percutaneous valves were implanted in 16 patients with TV bioprosthesis dysfunction (9 females) from 2 centers. Median age and weight were 31.3 years (5-77.2) and 65.2 kg (17.7-107); 14 patients had congenital heart disease (univentricular heart with a right atrial to right ventricle bioprosthesis in 3, Ebstein's anomaly of the TV in 5, and other in 6), and 2 had acquired TV dysfunction. All procedures were successful (Melody n=7, Sapien 26 mm valve n=4, Sapien XT 29 mm valve n=6). One valve showed early dysfunction. It was replaced surgically and shortly after that a repeated PTVI was performed. The median duration of follow-up was 2.1 years (3 days to 6.3 years). The percutaneous valve was performing well in 15 of 16 patients. CONCLUSIONS: PTVI was safe and effectively improved TV function in all but 1 patient at midterm follow-up. We think that PTVI is a good alternative to repeated surgical TV replacements and that it may reduce the total number of open heart surgeries in these patients.


Subject(s)
Heart Valve Prosthesis Implantation , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve/surgery , Administration, Cutaneous , Adolescent , Adult , Aged , Bioprosthesis/statistics & numerical data , Child , Child, Preschool , Female , Follow-Up Studies , Germany , Humans , Male , Middle Aged , Treatment Outcome , Tricuspid Valve/abnormalities , Tricuspid Valve Insufficiency/congenital , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL