DK2985_C000 1..28 - AlSharqia Echo Club

Pulmonic and Tricuspid Valves 451(A)(B)AoLBCVPAPEPVLCPVACRVOTFigure 19.5 Upper esophageal sagittal view of the right ventricular outflow tract (RVOT) and pulmonic valve (Ao, aorta; LBCV, left brachiocephalicvein; PA, pulmonary artery; PE, pericardial effusion; PVAC, pulmonic valve anterior cusp; PVLC, pulmonic valve left cusp).annuloplasty for significant TR in the setting of concomitantcardiac surgery (Fig. 19.12). A tricuspid annular dilatation.50 mm is associated with a lower likelihood ofright ventricular function recovery following repair (14).Common causes of pulmonary hypertension leading tofunctional TR include left ventricular failure and mitralvalve disease, both easily identified by TEE. Othercauses are thromboembolic pulmonary vascular disease,autoimmune pulmonary vascular disease, and primarypulmonary hypertension (12,15).Tricuspid regurgitation secondary to structural diseasemay implicate one of many mechanisms, such as leaflet(A)(B)TVPLLARARVTVAL(C)Vel: 259 cm/secPG: 28.3 mmHgFigure 19.6 (A, B) Mid-esophageal 1208 view with rightward rotation, demonstrating the anterior and posterior tricuspid leaflets, theright atrium (RA) and the atrial septum in a 77-year-old woman scheduled for tricuspid valve annuloplasty. (C) The peak systolic pressuregradient (PG) measured from the continuous-wave Doppler tricuspid regurgitant signal is 28.3 mmHg (LA, left atrium; RV, rightventricle; TVAL, tricuspid valve anterior leaflet; TVPL, tricuspid valve posterior leaflet; Vel, velocity).