Tricuspid stenosis

Outlined three separate piercing rheumatic valve stenosis extremely rare. Tricuspid stenosis associated with almost all of mitral and / or aortic valve disease, but both tricuspid regurgitation. As in the aftermath of rheumatic fever, and pathological changes similar to mitral stenosis, valve thickening fibrosis, a marginal growth of vegetation, 3 valve mutual adhesion or integration, forming a narrow triangular flap Kong. Lesions may also be extended and tendons and papillary muscles. Tricuspid lesions but the extent and scope of Light mitral valve under Fusion rarely see, and with minimal calcium deposition. After the formation of a narrow, right atrium flow right ventricular inflow occurred when barriers, thereby expanding the right atrium, the pressure increased. As cavity venous obstruction, chronic venous pressure increased, showing jugular vein engorgement, hepatomegaly, ascites and swelling of the limbs, and other symptoms. Right ventricle due to reduced blood flow to shrink. Associated with mitral valve disease, right ventricular hypertrophy can be. Clinical manifestations tricuspid stenosis of the main symptoms of gastrointestinal blood and the liver and spleen caused by depression, such as liver discomfort, loss of appetite, dyspepsia and abdominal distension, etc.. Sometimes accompanied by fatigue and swelling of the limbs. Simple tricuspid stenosis, lung and heart disease, as little more than that associated with mitral stenosis patients, but also due to right ventricular blood flow reduction, Simple cardiopulmonary symptoms compared with mitral stenosis of light. Visibility cheek medical examination mild cyanosis and jaundice (chronic liver depression caused blood). Jugular venous engorgement, or even pulsate. Hepatomegaly, quality flaky, tender, sometimes palpable systolic ago to beat. Ascites, abdominal swelling, mobile voiced. Heart checks, heart to the right side voiced sector expansion. No. 1 tricuspid Music hyperthyroidism, two auditions will be open smack sound. Breastbone left edge of the first four intercostal heard before systolic or diastolic drum-like noise can sometimes touching tremor. Deep breathing, chest negative pressure, right atrial blood flow increased significantly enhanced noise, and phase identification of mitral stenosis. Simple diagnosis of tricuspid stenosis is not easy to diagnose cases, but in the United valve disease, tricuspid stenosis tend to be ignored, should be vigilant. If necessary, right heart catheterization. Suspicious individual cases, heart surgery, the finger exploration by the right atrium could be identified. For the treatment of tricuspid stenosis, in principle, mitral stenosis and the same, Closed expansion but for the separation easier torn valve regurgitation caused serious, it has not advocated. (1) tricuspid patient with applicable to the junction of pure fusion, a good valve cases. By the right atrium, look under the knife incision were separated before the flap and flap and flap valve and repeat it at the junction of the integration, so that it separated into two valve leaflets. Open before and after the flap valve at the junction of easy integration have serious insufficiency and should be careful. (2) tricuspid valve replacement in severely damaged valve deformity or a cake insufficiency. Surgical incision through the right atrium. Resection valve placed sutures and artificial valve implantation steps are basically the same as mitral valve replacement. It should be noted, however : ① tricuspid valve ring structure enough resilience to wear slit valve Central sutures are required to take anti-tear pads; ② on alternate valve suture site through an annulus to prevent injury conduction beam; Given the high ③ after tricuspid valve thrombosis, and the pressure valve over aortic and mitral valve were small, artificial valve replacement is more appropriate. Auxiliary X-ray inspection : before-after photos show the right lower part of the right to expand cardiomegaly, superior vena cava shadow widened. Tricuspid stenosis in simple, clear lung fields and no pulmonary or lung blood Yu. ECG characteristics of P wave is increased, but no right ventricular hypertrophy phenomenon. Echocardiographic examination : Sonic back to the tricuspid and mitral stenosis similar tricuspid stenosis patients, the double curve disappeared, EF of the deceleration slowed, showing Qiangduo like change. Diastolic septal leaflet unusual activities, and the right atrial enlargement; In the right ventricular end diastolic pressure rise, the AC extension. Plane echocardiography showed tricuspid valve thickening, the diastolic opening activities restricted. Right heart catheterization showed a right atrial pressure increased significantly. The right atrium and right ventricle significantly before the systolic or diastolic pressure gradient. generally 0.5 ~ 1.1kPa (~ 4 mmHg). Cardiovascular imaging : catheter tip placed in the right atrium. Right anterior oblique film radiography can show that the tricuspid valve thickening, activity weakened, Contrast Agent in diastolic by narrow valve hole into the right ventricle and right atrium contrast agent emptying time. Differential diagnosis of right atrial myxoma, when the tumor blocking valve hole, could create tricuspid stenosis, a clinical performance, but short history, rapid disease progression, echocardiography unique hazy images, we can identify.