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Severe isolated tricuspid insufficiency in coronary artery disease
Insights
Severe tricuspid insufficiency can cause cardiac disability in patients with coronary artery disease. Surgical correction, like DeVega annuloplasty, is feasible when left ventricular function is preserved.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Coronary artery disease (CAD) can lead to complex cardiac complications.
- Tricuspid insufficiency (TI) is a potential complication, often associated with right heart failure.
Observation:
- Three patients with severe coronary artery disease presented with significant cardiac disability.
- Clinical signs included right heart failure, a tricuspid regurgitant murmur, and preserved left ventricular function.
Findings:
- Echocardiography and cardiac catheterization confirmed severe tricuspid insufficiency, right ventricular dilation, and impaired right ventricular function.
- Left ventricular function remained preserved in all patients.
- Two patients underwent successful DeVega annuloplasty for tricuspid insufficiency.
Implications:
- Symptomatic tricuspid insufficiency is a recognized complication in severe coronary artery disease.
- Surgical intervention for tricuspid insufficiency is a viable option when left ventricular function is well-preserved.
Abstract:
We describe 3 patients who presented with severe cardiac disability as a result of tricuspid insufficiency, in the setting of severe coronary disease. Pertinent physical findings were signs of right heart failure, a tricuspid regurgitant murmur, and absence of left heart failure. Echocardiography and subsequent cardiac catheterization demonstrated significant tricuspid insufficiency, dilated right ventricle, impairment of right ventricular function, and preserved left ventricular function. Two patients were treated successfully with DeVega annuloplasty. Symptomatic tricuspid insufficiency can be seen in the setting of coronary artery disease and, when left ventricular function is well preserved, surgical correction is feasible.