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Management of tricuspid regurgitation

Secondary tricuspid regurgitation is the most frequent type of tricuspid insufficiency in western countries. Its surgical treatment is still an object of debate both in terms of timing and surgical techniques. Until recently, the avoidance of surgery for tricuspid repair was commonly accepted in pat...

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Autores principales: De Bonis, Michele, Taramasso, Maurizio, Lapenna, Elisabetta, Alfieri, Ottavio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculty of 1000 Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108951/
https://www.ncbi.nlm.nih.gov/pubmed/25184048
http://dx.doi.org/10.12703/P6-58
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author De Bonis, Michele
Taramasso, Maurizio
Lapenna, Elisabetta
Alfieri, Ottavio
author_facet De Bonis, Michele
Taramasso, Maurizio
Lapenna, Elisabetta
Alfieri, Ottavio
author_sort De Bonis, Michele
collection PubMed
description Secondary tricuspid regurgitation is the most frequent type of tricuspid insufficiency in western countries. Its surgical treatment is still an object of debate both in terms of timing and surgical techniques. Until recently, the avoidance of surgery for tricuspid repair was commonly accepted in patients with less than severe secondary tricuspid regurgitation undergoing left-sided valve surgery. More recently, compelling evidence in favour of a more aggressive surgical approach in this setting has emerged. The surgical technique should be tailored to the stage of disease. Ring annuloplasty is more durable than suture annuloplasty and represents the method of choice in the presence of isolated annular dilatation. In patients in whom the dilatation of the tricuspid annulus is combined with significant leaflet tethering, annuloplasty alone is unlikely to be durable and additional procedures have been proposed in order to achieve a more durable repair. In this review, pathophysiology, surgical indications, techniques of repair and outcomes of secondary tricuspid regurgitation will be discussed. We will also focus on the challenging issue of significant tricuspid regurgitation occurring late after left-sided valve surgery. Finally, the current and future role of percutaneous tricuspid valve technologies will be briefly described.
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spelling pubmed-41089512014-09-02 Management of tricuspid regurgitation De Bonis, Michele Taramasso, Maurizio Lapenna, Elisabetta Alfieri, Ottavio F1000Prime Rep Review Article Secondary tricuspid regurgitation is the most frequent type of tricuspid insufficiency in western countries. Its surgical treatment is still an object of debate both in terms of timing and surgical techniques. Until recently, the avoidance of surgery for tricuspid repair was commonly accepted in patients with less than severe secondary tricuspid regurgitation undergoing left-sided valve surgery. More recently, compelling evidence in favour of a more aggressive surgical approach in this setting has emerged. The surgical technique should be tailored to the stage of disease. Ring annuloplasty is more durable than suture annuloplasty and represents the method of choice in the presence of isolated annular dilatation. In patients in whom the dilatation of the tricuspid annulus is combined with significant leaflet tethering, annuloplasty alone is unlikely to be durable and additional procedures have been proposed in order to achieve a more durable repair. In this review, pathophysiology, surgical indications, techniques of repair and outcomes of secondary tricuspid regurgitation will be discussed. We will also focus on the challenging issue of significant tricuspid regurgitation occurring late after left-sided valve surgery. Finally, the current and future role of percutaneous tricuspid valve technologies will be briefly described. Faculty of 1000 Ltd 2014-07-08 /pmc/articles/PMC4108951/ /pubmed/25184048 http://dx.doi.org/10.12703/P6-58 Text en © 2014 Faculty of 1000 Ltd http://creativecommons.org/licenses/by-nc/3.0/legalcode All F1000Prime Reports articles are distributed under the terms of the Creative Commons Attribution-Non Commercial License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
De Bonis, Michele
Taramasso, Maurizio
Lapenna, Elisabetta
Alfieri, Ottavio
Management of tricuspid regurgitation
title Management of tricuspid regurgitation
title_full Management of tricuspid regurgitation
title_fullStr Management of tricuspid regurgitation
title_full_unstemmed Management of tricuspid regurgitation
title_short Management of tricuspid regurgitation
title_sort management of tricuspid regurgitation
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108951/
https://www.ncbi.nlm.nih.gov/pubmed/25184048
http://dx.doi.org/10.12703/P6-58
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