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During open heart surgery for another issue (e.g. mitral valve), fixing the tricuspid valve may be considered, but medical consensus is unclear. Some argue that even mild to moderate tricuspid regurgitation should be addressed, while others take a more conservative approach. Infective endocarditis or traumatic lesions are other indications. [14]
Mitral regurgitation, also known as mitral insufficiency or mitral incompetence, is the backward flow of blood from the left ventricle, through the mitral valve, and into the left atrium, when the left ventricle contracts, resulting in a systolic murmur radiating to the left armpit. [5] [3]
In The Framingham Heart Study presence of any severity of tricuspid regurgitation, ranging from trace to above moderate was in 82% of men and in 85.7% of women. [2] Mild tricuspid regurgitation tend to be common and benign and in structurally normal tricuspid valve apparatus can be considered a normal variant. [1]
Tricuspid regurgitation is usually secondary to right ventricular dilation [16] which may be due to left ventricular failure (the most common cause), right ventricular infarction, inferior myocardial infarction, [16] or cor pulmonale [16] Other causes of tricuspid regurgitation include carcinoid syndrome and myxomatous degeneration.
Since the main causes of right ventricular hypertrophy is tricuspid regurgitation or pulmonary hypertension (discussed above), management involves treatment of these conditions. [3] Tricuspid regurgitation is typically treated conservatively by aiming to treat the underlying cause and following up the patient regularly. [12]
The natural history of mitral stenosis secondary to rheumatic fever (the most common cause) is an asymptomatic latent phase following the initial episode of rheumatic fever. This latent period lasts an average of 16.3 ± 5.2 years. Once symptoms of mitral stenosis begin to develop, progression to severe disability takes 9.2 ± 4.3 years.
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