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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-nine patients with different tricuspid valve (TV) pathologies were studied by both two-dimensional transthoracic (2DTTE) and live/real time three-dimensional transthoracic echocardiography (3DTTE). A major contribution of 3DTTE over 2DTTE was the en face visualization of all three leaflets of the TV in all patients. This allowed accurate assessment of TV orifice area in patients with TV stenosis and carcinoid disease. Loss of TV leaflet tissue, defects in TV leaflets and size of TV systolic non-coaptation could also be delineated and resulted in identifying the mechanism of tricuspid regurgitation (TR) in patients with Ebstein's anomaly and rheumatic heart disease. Prolapse of TV leaflets could also be well visualized and enabled us to develop a schema for systematic assessment of individual segment prolapse which could help in surgical planning. The exact sites of chordae rupture in patients with flail TV as well as right ventricular papillary muscle rupture could be well seen by 3DTTE. 3DTTE also permitted sectioning of various TV masses for more specific diagnosis of their nature. In addition, color Doppler 3DTTE provided an estimate of quantitative evaluation of TR severity, since the exact shape and size of the vena contracta could be accurately assessed. In conclusion, our preliminary experience with 3DTTE has demonstrated substantial incremental value over 2DTTE in the assessment of various TV pathologies.
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PMID:Live/real time three-dimensional transthoracic echocardiographic assessment of tricuspid valve pathology: incremental value over the two-dimensional technique. 1745 74

We report the case of a 52-year-old man who was referred to surgery because of severe mitral and tricuspid regurgitation of Barlow's disease. In particular, the tricuspid valve was a 'four-leaflet valve' due to the presence of a small accessory leaflet between the septal and the posterior leaflets. The valve insufficiency was determined by prolapse of all leaflets (in particular of the anterior and posterior ones) associated with annular dilatation. The patient underwent both mitral and tricuspid valve repair. The tricuspid regurgitation was corrected by stitching together the middle point of the free edges of the tricuspid leaflets producing a 'four-leaflet clover-shaped' valve. Surgical and echocardiographic images of the repaired valve are reported.
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PMID:'Four-leaflet clover repair' of severe tricuspid valve regurgitation due to complex lesions. 1860 54

The geometric and hemodynamic determinants of functional tricuspid regurgitation severity are mainly determined by septal leaflet tethering, septal-lateral annular dilatation, and the severity of pulmonary hypertension. Isolated significant tricuspid regurgitation can occur from isolated prolapse of valvar leaflets. Tricuspid prolapse has been found more frequently to be associated with mitral valve prolapse or with other cardiac and lung diseases and it has been rarely found as an isolated finding. Isolated primitive tricuspid prolapse appears in fact a relatively unknown anatomo-clinical entity and is of clinical importance, since this condition may be associated with significant tricuspid incompetence, a high incidence of cardiac arrhythmias, and possibly with bacterial endocarditis. We present a case of isolated prolapse of the tricuspid septal leaflet in an 11-year-old Italian boy. Also this case is illustrative of an isolated tricuspid prolapse.
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PMID:Isolated tricuspid prolapse in young child. 1865 32

Cardiac valve lesions after a blunt chest trauma are rare and less than 1% of cardiac lesions because of chest trauma affect the tricuspid valve. We report a 70 year-old female that suffered a severe chest trauma in a car accident. During the repair of the multiple skeletal lesions, the patient had a severe hemodynamic decompensation. A myocardial trauma with pericardial effusion and massive tricuspid insufficiency, due to anterior leaflet prolapse, was diagnosed on echocardiography. After discharge the patient remained in functional class II, with hepatomegaly, jugular ingurgitation and lower limb edema. A control echocardiogram, performed six months after the accident, showed dilatation of right heart chambers and massive tricuspid insufficiency. The patient was operated, and a tricuspid valve repair was performed suturing the ruptured papillary muscle to the ventricular wall and performing a tricuspid annuloplasty with a prosthetic ring. After 15 months of follow up, the patient remains asymptomatic.
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PMID:[Massive tricuspid valve insufficiency after blunt chest trauma: report of one case]. 1894 89

In a 77-year-old man with a history of arterial hypertension, coronary heart disease, dilative cardiomyopathy, mitral and tricuspid insufficiency, arteriovenous block III, implantation of a pacemaker, atrial fibrillation, and heart failure, left ventricular hypertrabeculation (LVHT) was detected on transthoracic echocardiography during hospitalization for worsening heart failure. Revision of previous echocardiography did not show LVHT in any of the previous investigations why LVHT was interpreted as acquired. The additional presentation with bilateral ptosis, madarosis (absent eyelashes), bilateral hypoacusis, sore neck muscles, absent tendon reflexes, weakness for foot extension, ataxic stance, and recurrently elevated creatine kinase with normal troponin-T suggested a metabolic myopathy. Autopsy after death resulting from intractable heart failure, 17 months later, confirmed severe coronary heart disease and LVHT in the apex. The case confirms that LVHT may be acquired in single cases with neuromuscular disease and may represent an adaptive mechanism of an impaired myocardium.
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PMID:Acquired noncompaction associated with coronary heart disease and myopathy. 2045 46

A 54-year-old man, scheduled for a clavicle fracture repair, appeared asymptomatic with 120 beats x min(-1) tachycardia and ECG abnormalities in preoperative anesthetic interview. He was not suffering from pain derived from clavicle fracture despite tachycardia. He was consulted with a cardiac physician. Downward displacement of tricuspid valve was detected by echocardiography and he was diagnosed Ebstein's anomaly. Right-left shunt did not exist, tricuspid regurgitation was grade I, and LV function was within normal ranges. Hence our anesthetic goal was to avoid arrhythmia, anesthesia was induced and maintained with propofol and remifentanil, and arterial pressure-based cardiac output monitor (FloTrac, Edwards Lifesciences, Irvine, CA, USA) was applied to measure cardiac output. Consequently, heart rate was controlled adequately, and intraoperative anesthetic course was uneventful. The number of adult patients with congenital heart disease has increased because techniques of echocardiography and surgical procedure have been improved. Anesthesiologists should be more aware of congenital heart disease in adults.
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PMID:[Ebstein's anomaly in an adult patient detected by sinus tachycardia by preoperative anesthetic interview]. 2056 Mar 89

While minimally invasive approaches are used routinely to correct severe mitral regurgitation due to leaflet prolapse, isolated tricuspid valve prolapse is less frequent and usually addressed via sternotomy. A 34-year-old female presented with exertional dyspnea and severe tricuspid regurgitation due to an unsupported anterior leaflet causing prolapse, a tethered septal leaflet, and dilated annulus. Herein, the technique is described of a robot-assisted tricuspid valve repair using established open valvuloplasty principles. The robotic repair was performed by the placement of Gore-Tex neochordae from the anterior papillary muscle to the anterior tricuspid leaflet, plication of the anteroseptal and anteroposterior commissures, closure of an anterior leaflet cleft, and the insertion of an annuloplasty band. The patient had an uncomplicated hospital course and was dismissed home on the third postoperative day.
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PMID:Robot-assisted repair of tricuspid leaflet prolapse using standard valvuloplasty techniques. 2340 56

Quadrangular resection is the gold standard technique for correction of the posterior leaflet prolapse in mitral valve disease. Prompted by the idea that the anterior leaflet of the tricuspid valve corresponds to the posterior leaflet of the mitral valve in its structure and function, we conducted a quadrangular resection of the anterior leaflet of the tricuspid valve in a case of tricuspid endocarditis. Tricuspid regurgitation was well corrected, and the durability of the repair was proven by the patient's freedom from cardiac events for the following 8 years.
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PMID:Quadrangular resection of the tricuspid valve. 2342 78

This retrospective study attempted to establish the prevalence of multiple-valve involvement in Marfan syndrome and to compare echocardiographic with histopathologic findings in Marfan patients undergoing valvular or aortic surgery. We reviewed echocardiograms of 73 Marfan patients who underwent cardiovascular surgery from January 2004 through October 2009. Tissue histology was available for comparison in 29 patients. Among the 73 patients, 66 underwent aortic valve replacement or the Bentall procedure. Histologic findings were available in 29 patients, all of whom had myxomatous degeneration. Of 63 patients with moderate or severe aortic regurgitation as determined by echocardiography, 4 had thickened aortic valves. The echocardiographic findings in 18 patients with mitral involvement included mitral prolapse in 15. Of 11 patients with moderate or severe mitral regurgitation as determined by echocardiography, 4 underwent mitral valve repair and 7 mitral valve replacement. Histologic findings among mitral valve replacement patients showed thickened valve tissue and myxomatous degeneration. Tricuspid involvement was seen echocardiographically in 8 patients, all of whom had tricuspid prolapse. Two patients had severe tricuspid regurgitation, and both underwent repair. Both mitral and tricuspid involvement were seen echocardiographically in 7 patients. Among the 73 patients undergoing cardiac surgery for Marfan syndrome, 66 had moderate or severe aortic regurgitation, although their valves manifested few histologic changes. Eighteen patients had mitral involvement (moderate or severe mitral regurgitation, prolapse, or both), and 8 had tricuspid involvement. Mitral valves were most frequently found to have histologic changes, but the tricuspid valve was invariably involved.
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PMID:Echocardiographic versus histologic findings in Marfan syndrome. 2587 95

We present the two-dimensional echocardiographic findings of tricuspid valve prolapse with mid-to-late systolic tricuspid regurgitation and describe the incremental value provided by live/real time three-dimensional transthoracic echocardiography. We also discuss a potential pitfall when assessing the severity of regurgitation in this setting.
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PMID:Two- and Three-dimensional Transthoracic Echocardiographic Assessment of Tricuspid Valve Prolapse with Mid-to-Late Systolic Tricuspid Regurgitation. 2590 19


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