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Related Concept Videos

Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation II: Clinical Features and Diagnostic Tests01:23

Mitral Regurgitation II: Clinical Features and Diagnostic Tests

Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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...
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...

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Related Experiment Video

Updated: Jul 18, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Association Between Functional Tricuspid Regurgitation and Mortality Following Cardiac Surgery.

Timothy C Tan1, Louis Mullie2, Aidan W Flynn1

  • 1Cardiac Ultrasound Laboratory, Division of Cardiology, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA.

JACC. Advances
|June 28, 2024
PubMed
Summary

Moderate functional tricuspid regurgitation (TR) in cardiac surgery patients is linked to higher mortality and morbidity, especially without pulmonary hypertension. This finding impacts surgical repair guidelines for non-severe TR.

Keywords:
cardiac surgeryechocardiographymortalitytricuspid regurgitation

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Current guidelines suggest repairing some non-severe tricuspid regurgitation (TR) during cardiac surgery.
  • The prognostic significance and post-operative outcomes of TR remain unclear.

Purpose of the Study:

  • To assess the prognostic impact of functional TR in various cardiac surgeries.
  • To identify patient characteristics that modify the risk associated with TR.

Main Methods:

  • Included patients undergoing coronary artery bypass, aortic, and mitral valve surgery.
  • Excluded severe TR, organic tricuspid valve disease, tricuspid valve surgery, or lack of recent echocardiogram.
  • Utilized data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database and an external validation cohort.

Main Results:

  • Moderate TR (9%) was independently associated with increased mid-term mortality (HR: 2.58) and in-hospital mortality or major morbidity (OR: 3.18).
  • This association was significant in patients with pulmonary artery systolic pressure <40 mm Hg (P=0.036).

Conclusions:

  • Moderate functional TR independently predicts worse outcomes in contemporary cardiac surgery patients.
  • The increased risk of mortality and morbidity is particularly evident in patients without pulmonary hypertension.