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massive tricuspid regurgitation

added by Emmel

massive tricuspid regurgitation
Posted By: Emmel (1636 days ago)

Hallo Pablo,

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

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?
/>Best wishes and many greetings from overseas,

Posted By: ohtusabes (1662 days ago)

Don´t look so bad RV global function...do you measure RV fractional
area change?

Posted By: ohtusabes (1662 days ago)

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.

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Added: 30-10-2013
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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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