Dr Boris Orlov

Secondary Tricuspid Regurgitation
Pulmonary hypertension
In patients with left-sided valvular disease a rising left atrial pressure,
transmitted through the lungs as pulmonary arterial hypertension,
resulting in RV pressure overload and:
•can directly result in tricuspid regurgitation
OR
•more typically causes right ventricular dilatation, which leads to
dilatation and distortion of the tricuspid valve annulus (Carpentier
type I regurgitation) or/and by tethering of the tricuspid valve
leaflets (Carpentier type IIIb regurgitation )
At least in theory, reduction in degree of pulmonary hypertension (by
mitral valve repair) could result in less tricuspid regurgitation, but
this would first require reverse remodeling of the previously
dilated and deformated right ventricle, which may not be
instantaneous