massive tricuspid regurgitation
added by Emmel
massive tricuspid regurgitation
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Added: 30-10-2013
Runtime: 0m 14s
Views: 15608
Comments: 3 Current Rating:
(1 Votes)
Runtime: 0m 14s
Views: 15608
Comments: 3 Current Rating:
(1 Votes)
Description
very old patient with peripheral oedema and dyspnoea. no underlaying diseases are known. In TTE I could see a massive RA and RV dilatation with distinct tethering and tenting of tricuspid valve caused by RV dilatation. There is no coadaption of anterior and septale tricuspid cusps. PAPs was about 55 mmHg, I think the PAPs is very underexistimated by bernulli formula because of low RV function (TAPSE 8 mm, however the midventricular free RV wall seems to work better). CTEPH?.
very old patient with peripheral oedema and dyspnoea. no underlaying diseases are known. In TTE I could see a massive RA and RV dilatation with distinct tethering and tenting of tricuspid valve caused by RV dilatation. There is no coadaption of anterior and septale tricuspid cusps. PAPs was about 55 mmHg, I think the PAPs is very underexistimated by bernulli formula because of low RV function (TAPSE 8 mm, however the midventricular free RV wall seems to work better). CTEPH?.
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Hallo Pablo,
/>Best wishes and many greetings from overseas,
RVOT-measurement showed me indirectely a
distinct pulmonary hypertension: RVOT-VTI about 12 cm with dichromatic
doppler sign. Accerleration time was about 63 msec. Unfortunately I
could´t measure a good pw-doppler sign of pulmonary insufficiency for
measurement of PAPmean and PAPdiastolic.
But in this case there
weren´t any therapeutical consequences.
Sorry, I think one of
that pictures shows a A2C-view of the LEFT ventricle, NOT of the right
ventricle.
If that was a young patient, any ideas for
therapy? Maybe Reconstruction of tricupid valve (Annuloplasty with
carpentier-ring) and RV-Modulation/-reduction by surgery?
Jörg
Don´t look so bad RV global function...do you measure RV fractional
area change?
Amazing clip Jörg. Maybe PAPs is not real because of severity of TR.
When this happens there is virtually no gradient between RV and RA
(the door is always open). Maybe is better to use in this case
pulmonary artery aceleration time.