No abstract available.
Balloon Valvuloplasty* ; Tricuspid Valve Stenosis* ; Tricuspid Valve*

Intracardiac metastasis of hepatocellular carcinoma with functional tricuspid valve stenosis is not common. Furthermore, hepatopulmonary syndrome associated with hepatocellular carcinoma is rarely encountered. We present a case of intracardiac metastasis of hepatocellular carcinoma presenting with functional tricuspid valve stenosis accompanied with hepatopulmonary syndrome.
Carcinoma, Hepatocellular ; Echocardiography ; Heart Ventricles ; Hepatopulmonary Syndrome ; Neoplasm Metastasis ; Tricuspid Valve ; Tricuspid Valve Stenosis

In order to determine the meaning of tricuspid stenosis(TS) in rhematic valvular heart disease(RVHD), 310 consecutive patients with RVHD were assessed by Doppler and 2-dimensional(2D) echocardiography. The frequency of 2D echocardiographic TS(diastolic doming of anterior tricuspid leaflet and thickened tricuspid leaflets) was 8.4%, and all patients with 2D echocardiographic TS had the mean tricuspid pressure gradient(MTPG) of 1mmHg or more compared to normal control of less than 1mmHg with Doppler echocardiography. The frequency of clinically significant hemodynamic TS(MTPG>2mmHg) and of servere hemodynamic TS(MTPG>5mmHg) in RVHD were 3.5% and 0.6% respectively. Rheumatic TS was accompanied by tricuspid regurgitation in the frequency of 92.3% and did not occurs in pure mitral regurgitation. Rhematic TS occurs with high frequency in advanced rheumatic valvular stenosis, and the frequency of rheumatic TS in severe rheumatic mitral stenosis and mitral stenosis coexing with aortic stenosis were 20.8% and 23.9% respectively. The results indicates that TS in RVHD is little practical meaning but is unable to disregard especially in the cases of advanced rhematic valvular stenosis, and there is need to recognize of TS in RVHD.
Aortic Valve Stenosis ; Constriction, Pathologic* ; Echocardiography* ; Echocardiography, Doppler ; Heart ; Hemodynamics ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Tricuspid Valve Insufficiency

Left atrial dissection does occur, though rarely, after mitral valve surgery. A 68-year-old Korean female presented with moderate mitral stenosis, mild mitral regurgitation, moderate tricuspid regurgitation and mild aortic regurgitation. She was scheduled for mitral valve replacement and tricuspid annuloplasty. We experienced a left atrial dissection after weaning from cardiopulmonary bypass and decided not to repair it. The patient recovered uneventfully. We suggest that a specific type of left atrial dissection can be treated conservatively.
Aged ; Aortic Valve Insufficiency ; Cardiopulmonary Bypass ; Female ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Tricuspid Valve Insufficiency

Hemoptysis occurs quite frequently as a consequence of mitral stenosis, but massive, lirE threatening pulmonary hemorrhage is distinctly unusual. We report a 30 year old female who underwent cmcrgcncy rcdo double valve replacement for intractable pulmonary hemorrhage. she underwent mitral valve replacement (lonescu Shirley 27 mm) due to rheumatic valvular heart disease in 1984 and tricuspid valve annuloplasty (Carpentier's ring 30mm) two years later She was admitted for massive hcmoptysis and dyspnea on the 26th of December, 1995. Medical treatment including transarterial embolization was given but was not satisfactory. Emergency valve replacement (Mitral valve, St. Judc 29mm and tricuspid valve ; St. Jude 33mm) was performed and hemoptysis was controlled dramatically 24 hours after surgery.
Adult ; Dyspnea ; Emergencies* ; Female ; Heart Valve Diseases* ; Hemoptysis* ; Hemorrhage ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Tricuspid Valve

INTRODUCTION: Cardiac hemangiomas are rare benign primary tumors.We present the successful management of a patient with a hemangioma causing significant right ventricular outflow tract (RVOT) obstruction.
CLINICAL PRESENTATION: A 54-year-old  female  with  no  co-morbidities  presented  with  progressive  right-sided  heart failure  symptoms.Examination  revealed  a  prominent right  ventricular  heave,  irregular  cardiac  rhythm,murmurs  consistent  with  pulmonic  stenosis  and  tricuspid regurgitation,  ascites,  and  bipedal  edema.  Given the echo features of the mass and the patient's clinical course,we  favored  a  benign  cardiac  tumor  over  malignancy.Differentials included  myxoma,  fibroma,  and  papillary fibroelastoma. Medical management included enoxaparin and carvedilol as anticoagulation and rate control for the atrial flutter, respectively. Surgical treatment consisted of tumor excision and tricuspid valve annuloplasty.
RESULTS: Intra-operatively, the stalk was indeed attached to the RV free wall. Histopathology was consistent with primary cardiac hemangioma. The patient's post-operative course was complicated by pneumonia, acute kidney injury, and tracheostomy, but she was eventually discharged improved after a month in the ICU.
SIGNIFICANCE: This report highlights a rare primary cardiac tumor in an unusual location. While there have been several reports in the world literature on cardiac hemangiomas, less than ten cases have been shown to have significant RVOT obstruction as in our patient.
CONCLUSION: Cardiac hemangiomas should be part of the differential diagnosis for an intracardiac mass in the right ventricle.  Meticulous  echocardiography  can  be  a  non-invasive and inexpensive aid to diagnosis and pre-operative planning.

Human ; Female ; Middle Aged ; Tricuspid Valve ; Carvedilol ; Enoxaparin ; Tricuspid Valve Insufficiency ; Heart Ventricles ; Tracheostomy ; Myxoma ; Heart Neoplasms ; Propanolamines ; Hemangioma ; Pulmonary Valve Stenosis

Humans ; Male ; Middle Aged ; Pacemaker, Artificial ; adverse effects ; Tricuspid Valve Stenosis ; etiology

Aseptic endocarditis is an uncommon complication of Behcet's disease (BD). We describe a rare case of a 39-year-old female who had BD with aseptic endocarditis of the tricuspid valve (TV) presenting as tricuspid stenosis. She was diagnosed with BD four years ago. The mucocutaneous lesions were well-controlled with colchicine and short courses of corticosteroids. She remained free of signs and symptoms of BD for one year without any medication. Three months before admission, she gradually developed dyspnea on exertion and peripheral edema. Echocardiography revealed dilated right atrium and markedly thickened TV with severe stenosis. TV replacement was performed. Pathologic examination of the valve showed fibrinoid necrotic material and inflammatory cell infiltration. Blood cultures and cultures of the excised valve were negative for microorganisms.
Adrenal Cortex Hormones ; Adult ; Behcet Syndrome ; Colchicine ; Constriction, Pathologic ; Dyspnea ; Echocardiography ; Edema ; Endocarditis ; Female ; Heart Atria ; Humans ; Tricuspid Valve ; Tricuspid Valve Stenosis

A 44-year-old man had been admitted for dyspnea on exertion and abdominal distension. The echocardiography revealed abnormal mass in right atrium and tricuspid valve stenosis with right ventricular obliteration. The operation was performed with mass removal, enlargement of tricuspid valve opening, and right ventricular endocardiectomy. And then, atrial septal defect was made due to inadequate right ventricular volume. The patient's symptom was improved and he discharged without events. The endomyocardial fibrosis was diagnosed with microscopic examination. Eighteen months later, the patient was readmitted due to aggravated dyspnea and cyanosis. The right ventricular obliteration was progressed and pulmonary blood flow was severely decreased in follow up echocardiography. Palliative bidirectional cavo-pulmonary shunt was performed due to functional single ventricle. The dyspnea and cyanosis was markedly improved. Bidirectional cavo-pulmonary shunt for advanced and isolated right ventricular endomyocardial fibrosis provided effective palliation at early postoperative period, However, long-term follow up is mandatory.
Adult ; Cyanosis ; Dyspnea ; Echocardiography ; Endomyocardial Fibrosis* ; Follow-Up Studies ; Fontan Procedure* ; Heart Atria ; Heart Septal Defects, Atrial ; Humans ; Postoperative Period ; Tricuspid Valve ; Tricuspid Valve Stenosis

Obstructive intracardiac lesions, like mitral stenosis or insufficiency (MR), by myxomas of the left atrium have been commonly reported, but the attenuation of MR by myxoma combined with coronary artery disease is very rare. We report a 70-year-old female patient whose left atrial myxoma had attenuated moderate MR to mild MR and required mitral valve surgery after removal of the myxoma. She also had coronary artery disease, severe pulmonary hypertension and moderate tricuspid regurgitation due to the mitral valve lesions obstructed by myxoma. The patient underwent removal of myxoma, mitral and tricuspid valve reconstructions, and coronary artery bypass grafting. She was discharged at the postoperative 14 day without any problems.
Aged ; Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Heart Atria ; Humans ; Hypertension, Pulmonary ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis ; Myxoma* ; Tricuspid Valve ; Tricuspid Valve Insufficiency