Chronic traumatic tricuspid insufficiency.

Abstract:

:Isolated tricuspid insufficiency (TI) is relatively uncommon and mostly of traumatic origin. We report clinical noninvasive and invasive findings and surgical results in 5 cases. All patients had complete clinical, noninvasive and invasive studies including right and left catheterization, and coronary angiographies in 3 patients. All but 1 patient had nonpenetrating trauma. All had large jugular V waves, right precordial impulse, systolic liver pulse, positive Carvallo sign documented also by noninvasive techniques. Right heart failure was present in 3 patients. Chest x-ray showed prominent right atrium and distended vena cavae. Electrocardiogram showed normal sinus rhythm in 4 patients and atrial fibrillation in 1. Two patients had right bundle-branch block, and 2 presented RSR'-pattern. Echocardiogram showed large right atrium (RA) (6-10 cm), floppy tricuspid valve (TV) in all, dilated right ventricle (RV) in 2 patients. Findings of left heart were normal in all. Three patients had right-to-left shunt. In RA A waves were 4-8, Y waves 1-3, and V waves 12-22 mmHg, respectively (mean RV and PA pressures were 23/3 and 23/10 mmHg, respectively). Four patients had anuloplasty, 2 of them repair of valve and chordae. Surgical results were good in 2 patients with valve repair, satisfactory in 1; there was significant TI resistance in 1 case. We conclude that TI has distinctive clinical findings and must be ruled out in all patients with chest trauma. Surgery must include not only anuloplasty, but, cusps and chordae must also be evaluated and reconstructed if necessary.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Sheikhzadeh A,Langbehn AF,Ghabusi P,Hakim C,Wendler G,Tarbiat S

doi

10.1002/clc.4960070509

subject

Has Abstract

pub_date

1984-05-01 00:00:00

pages

299-306

issue

5

eissn

0160-9289

issn

1932-8737

journal_volume

7

pub_type

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