scholarly journals Strategies for Managing Functional Tricuspid Regurgitation in Adults With a Secundum Atrial Septal Defect

2017 ◽  
Vol 10 (21) ◽  
pp. 2219-2221 ◽  
Author(s):  
Gary D. Webb ◽  
Alexander R. Opotowsky
Keyword(s):  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Secundum Atrial Septal Defect ◽  
Functional Tricuspid Regurgitation

scholarly journals Tricuspid Regurgitation in Ostium Secundum Atrial Septal Defects: Repair or Not?

2020 ◽  
Vol 23 (2) ◽  
pp. E239-E244 ◽  
Author(s):  
Chirag Sumithra Prasanna Kumar ◽  
Bineesh K Radhakrishnan ◽  
Remya Sudevan ◽  
Jayakumar Karunakaran
Keyword(s):  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Pulmonary Artery Hypertension ◽  
Tricuspid Valve Repair ◽  
Secundum Atrial Septal Defect ◽  
Atrial Septal Defect Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Functional Tricuspid Regurgitation

Background: Longstanding ostium secundum atrial septal defects lead to functional tricuspid regurgitation. Significant functional tricuspid regurgitation associated with left heart valve disease is addressed at the time of primary left heart valve surgery. In contrast, there is no global recommendation for tricuspid regurgitation associated with atrial septal defects. This study assesses changes in tricuspid regurgitation after isolated atrial septal defect closure. Methods: Retrospectively, records were examined of 100 patients who underwent isolated ostium secundum atrial septal defect closure without tricuspid valve repair. Echocardiograms were done preoperatively and 3 days, 3 months, and 1 year after surgery. Data on tricuspid regurgitation status, right ventricle dimensions, and pulmonary artery hypertension status were collected and analyzed. Results: After surgical closure, echocardiography showed a regression of tricuspid regurgitation to mild or less in 76% of patients at 3 days, 89% at 3 months, and 93% at 1 year. Severe pulmonary artery hypertension (32% patients preoperatively) showed statistically significant regression: 14% at 3 days, 10% at 3 months, and 2% at 1 year. Preoperatively, the mean right ventricular internal diameter was 37.9 mm, which decreased to 34 ± 5.5 mm (mean ± standard deviation) at 3 days, 32.3 ± 5.3 mm at 3 months, and 31.3 ± 5.4 mm at 1 year. It was also noted that regression favored patients who were <25 years old. Conclusion: Tricuspid valve repair may not be required in patients with ostium secundum atrial septal defect with functional tricuspid regurgitation.

Persistent Tricuspid Regurgitation and Its Predictor in Adults After Percutaneous and Isolated Surgical Closure of Secundum Atrial Septal Defect

2009 ◽  
Vol 104 (6) ◽  
pp. 856-861 ◽  
Author(s):  
Manatomo Toyono ◽  
Richard A. Krasuski ◽  
Gosta B. Pettersson ◽  
Yoshiki Matsumura ◽  
Tetsuhiro Yamano ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Secundum Atrial Septal Defect ◽  
Surgical Closure

Surgical Strategy in Patients with Atrial Septal Defect and Severe Pulmonary Hypertension

2012 ◽  
Vol 15 (2) ◽  
pp. 111 ◽  
Author(s):  
Yang Hyun Cho ◽  
Tae-Gook Jun ◽  
Ji-Hyuk Yang ◽  
Pyo Won Park ◽  
June Huh ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Maze Procedure ◽  
Severe Pulmonary Hypertension ◽  
Tricuspid Annuloplasty ◽  
Pulmonary Arterial ◽  
Asd Closure

The aim of the study was to review our experience with atrial septal defect (ASD) closure with a fenestrated patch in patients with severe pulmonary hypertension. Between July 2004 and February 2009, 16 patients with isolated ASD underwent closure with a fenestrated patch. All patients had a secundum type ASD and severe pulmonary hypertension. Patients ranged in age from 6 to 57 years (mean � SD, 34.9 � 13.5 years). The follow-up period was 9 to 59 months (mean, 34.5 � 13.1 months). The ranges of preoperative systolic and pulmonary arterial pressures were 63 to 119 mm Hg (mean, 83.8 � 13.9 mm Hg) and 37 to 77 mm Hg (mean, 51.1 � 10.1 mm Hg). The ranges of preoperative values for the ratio of the pulmonary flow to the systemic flow and for pulmonary arterial resistance were 1.1 to 2.7 (mean, 1.95 � 0.5) and 3.9 to 16.7 Wood units (mean, 9.8 � 2.9 Wood units), respectively. There was no early or late mortality. Tricuspid annuloplasty was performed in 14 patients (87.5%). The peak tricuspid regurgitation gradient and the ratio of the systolic pulmonary artery pressure to the systemic arterial pressure were decreased in all patients. The New York Heart Association class and the grade of tricuspid regurgitation were improved in 13 patients (81.2%) and 15 patients (93.7%), respectively. ASD closure in patients with severe pulmonary hypertension can be performed safely if we create fenestration. Tricuspid annuloplasty and a Cox maze procedure may improve the clinical result. Close observation and follow-up will be needed to validate the long-term benefits.

Clinical and echocardiographic assessment of a right-to-left shunt across an atrial septal defect secondary to tricuspid regurgitation

2001 ◽  
Vol 56 (4) ◽  
pp. 233-237 ◽  
Author(s):  
Miroslaw KOWALSKI ◽  
Piotr HOFFMAN ◽  
Hanna SIUDALSKA ◽  
Ewa JABUKOWSKA ◽  
Wanda RYDLEWSKA-SADOWSKA
Keyword(s):  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Echocardiographic Assessment
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