Emergency tricuspid valve replacement can be a successful, life-saving intervention for patients with refractory cardiogenic shock caused by severe tricuspid regurgitation following acute right ventricular infarction.
A 66-year-old man had an acute inferior wall myocardial infarction complicated by hypotension, high-grade atrioventricular block, and distended neck veins, suggesting associated right ventricular infarction. He failed to respond to volume loading, intra-aortic balloon counterpulsation, and pharmacologic afterload reduction. Cardiac catheterization five days after the infarction disclosed severe tricuspid regurgitation and a hemodynamic pattern resembling pericardial constriction. Emergency tricuspid valve replacement was dramatically successful.
Kenneth S. Korr (Fri,) studied this question.