Does lowering pulmonary arterial pressure eliminate severe functional tricuspid regurgitation?
Insights from pulmonary thromboendarterectomy
H. Mehrdad Sadeghi, MD*,*,
Bruce J. Kimura, MD, FACC ,
Ajit Raisinghani, MD, FACC*,
Daniel G. Blanchard, MD, FACC*,
Ehtisham Mahmud, MD, FACC*,
Peter F. Fedullo, MD ,
Stuart W. Jamieson, MB and
Anthony N. DeMaria, MD, MACC*
* Cardiology, University of California-San Diego Medical Center, San Diego, California, USA
Pulmonary Medicine, University of California-San Diego Medical Center, San Diego, California, USA
Cardiothoracic Surgery, University of California-San Diego Medical Center, San Diego, California, USA
Division of Cardiology, Scripps-Mercy Hospital, San Diego, California, USA
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Figure 1 Pre- and postoperative severity of pulmonary hypertension (by echocardiographic measurements) as stratified by resolved (open bars) or persistent severe (solid bars) tricuspid regurgitation before and after pulmonary thromboendarterectomy (PTE). PAS = pulmonary artery systolic pressure.
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Figure 2 Apical four-chamber echocardiographic images with Doppler of a patient with severe tricuspid regurgitation (A) that resolved after pulmonary thromboendarterectomy (B). Pulmonary artery systolic pressure declined from 74 to 29 mm Hg after pulmonary artery systolic pressure.
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Figure 3 Apical four-chamber echocardiographic images with Doppler of a patient with severe tricuspid regurgitation (A) that persisted after pulmonary thromboendarterectomy (B). Pulmonary artery systolic pressure declined from 96 to 46 mm Hg after pulmonary artery systolic pressure.
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