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Tricuspid Valve Disease
Acquired disease of the tricuspid valve is uncommon and usually occurs in conjunction with mitral or aortic valve disease. The most common disease is insufficiency due to elevated lung pressures that occur secondary to left sided valve disease – i.e. mitral stenosis or aortic stenosis. Tricuspid stenosis can occur, but it most commonly happens secondary to disorders like carcinoid syndrome or fibrosis of the valve.
The majority of patients have little or no symptoms. If pressure in the right heart and lungs are normal or slightly elevated the significance of insuffiency or stenosis is usually not of clinical importance. Based on its significance tricuspid disease often requires no surgical intervention. If the lung pressures are elevated the tricuspid leakage may become greater. The patient may then realize subtle symptoms of dyspnea, liver congestion, ascites (fluid in abdomen) or leg swelling. These later symptoms may then require surgical treatment.
Most operations performed on the Tricuspid Valve are done for valve leakage. These interventions are done in conjunction with an aortic valve replacement or a mitral valve procedure. If the leaflets, of which there are three, are reasonably intact the valve can be repaired. This is either done with a permanent suture gathering the valve ring together. Or the procedure can be accomplished by placing a ring around the valve, which acts like a belt gathering the waist of a pair of pants that are too big. In rare situations the valve will need to be replaced most likely with animal tissue prosthesis. Your surgeon will make a decision if your right ventricle is healthy enough for a tricuspid repair or replacement.