Related Experiment Video
Updated: Oct 4, 2025
08:50
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
11.8K
Right heart failure and patient selection for isolated tricuspid valve surgery
Haytham Elgharably1, Ahmed Ibrahim1, Bradley Rosinski1
1Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
The Journal of Thoracic and Cardiovascular Surgery
|February 6, 2022
Summary
Isolated tricuspid valve surgery for right heart failure showed good early outcomes. Functional tricuspid regurgitation, though associated with worse long-term survival, may benefit from earlier intervention.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Right heart failure presents complex challenges in patients undergoing isolated tricuspid valve surgery.
- Understanding right ventricular morphology and function is crucial for surgical outcomes.
Purpose of the Study:
- To characterize patients with right heart failure undergoing isolated tricuspid valve surgery.
- To focus on right heart morphology and function in this patient cohort.
- To differentiate between functional and structural tricuspid regurgitation.
Main Methods:
- Retrospective analysis of 62 patients undergoing isolated tricuspid valve surgery (2007-2014).
- Echocardiographic assessment of right heart morphology and function.
- Cluster analysis to differentiate functional and structural tricuspid regurgitation.
- Extraction of clinical and hemodynamic data.
Main Results:
- Patients exhibited dilated right ventricles but preserved function.
- Functional tricuspid regurgitation (TR) was associated with worse right ventricular morphology and more severe right heart failure symptoms.
- Functional TR group had significantly higher Model for End-Stage Liver Disease with Sodium scores and worse long-term survival (48% vs 73% at 10 years).
Conclusions:
- Cluster analysis successfully separated functional and structural tricuspid valve disease.
- Good early surgical outcomes support expanding criteria for tricuspid valve surgery.
- Earlier intervention for functional TR in right heart failure patients is suggested.
Related Concept Videos
01:21Cardiac Catheterization II: Right Heart Catheterization
228
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
228
01:24Cardiac Catheterization III: Left Heart Catheterization
254
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
254
01:26Mitral Stenosis III: Medical Management
34
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
34
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
42
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
42
01:27Mitral Stenosis IV: Nursing Management
62
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
62
01:25Mitral Regurgitation III: Medical Management
45
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
45