Key result
Tricuspid valve replacement in patients with severe chronic tricuspid regurgitation may lead to a sudden increase in right ventricular afterload and unmask pulmonary hypertension.
Why the study?
Does tricuspid valve replacement unmask pulmonary hypertension in patients with severe chronic tricuspid regurgitation?
Does tricuspid valve replacement unmask pulmonary hypertension in patients with severe chronic tricuspid regurgitation?
Tricuspid valve replacement in severe tricuspid regurgitation carries the risk of unmasking pulmonary hypertension, necessitating careful preoperative assessment of RV function and pulmonary circulation.
In this Viewpoint, we highlight a possible hemodynamic problem arising following tricuspid valve replacement (TVR) in patients with severe chronic tricuspid regurgitation, represented by "unmasking" of pulmonary hypertension (PH) following the surgery. We share an observation that should alert cardiologists to the fact that this increasingly utilized surgery is not risk free, and careful assessment of the right ventricular function and pulmonary circulation preoperatively is extremely important, especially in patients with preexisting risk factors for PH, since TVR may lead to a sudden increase in right ventricular afterload.
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Ajam et al. (2020) conducted an editorial in Severe chronic tricuspid regurgitation. Tricuspid valve replacement was evaluated on Unmasking of pulmonary hypertension. Tricuspid valve replacement in patients with severe chronic tricuspid regurgitation may lead to a sudden increase in right ventricular afterload and unmask pulmonary hypertension.
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