tricuspid valve concerns

[lyneebee]

Has anyone of you have had symptoms of tricuspid problems diagnosed or repaired, or replaced? Last year through TEE Test I was told by my cardio that I had a tricuspid valve leaking, it wasnt a big deal to me because I did not know the difference between my mitral value replacement clicking or my TV leaking at that time. Recently, I was in the hospital for high fever and persistent cough, at first I was diagnosed in ER with phnemonia, x rays showed congestion. My primary and cardio were informed and told me that my
TV was leaking too much. My symptoms were coughing, left leg swollen and blood clot rashes, bloated stomach and sometimes my face would puff in the morning. My cardio said I may have to be opened up again ( MVR in 1995). I also have an A-fib that was never taken care of. My cardio has yet to discuss this with a surgeon and provide me with options. I do not know what questions I should ask my Doctor because I am just begginning to learn to know about this condition. My last year TEE report read that I had an enlarged right atrium. Tricuspid regurg of severe degree PA pres. 46mmGh. I have no idea about this figure. My cardio does not explain it very well to me. My last test has not come out yet. I'd like to know if someone of you has gone for repair or replacemnt. My cardio was talking of putting in a ring. I'm confused. Please advise.

 

[bvdr]

Hi Lynn. Welcome to this site. There are many of us here who also have a history of rheumatic fever leading to our valve replacements. I don't know how much you have researched valve issues but if you aren't aware of the connection of tri-cuspid valve problems with pulmonary hypertension I think it is time for you to become a scholar in that field.

I have mild pulmonary hypertension and as yet am not on an specific medications for it but your pressure is higher than mine and your symptoms are more severe. You may really benefit from being under the care of some one expert in the care of patients with pulmonary hypertension(PH).

I am very concerned you receive proper care! Please let us know what develops, OK?

 

[Mb]

Hello!

My husband had two valves implanted four and a half years ago.

He is in chronic a-fib. Both of his atrium have enlarged, as well as his ventricles. The atrium have enlarged from the a-fib. The right sided atrium has enlarged to the point where the flap of the valve no longer covers the opening completely. Sounds like you've got the same problem. It is NOT cuased by pulmonary hypertension, but the a-fib. Our last visist to the Dr. also revealed the same thing as you. Coming time to fix it up, before it causes other organ damage. (backflow into the liver, kidney issues, etc.)

My husband is cheduled to see his cardio in August,, and I am sure there will be more coming then. (His leakage has also been diagnosed as severe.)

The thought today is that the tricuspid valve is more important than originally thought, as its' failure causes slow progressive worsening of right sided heart failure. Sounds like you had a bout with it. The most important thing mys husband does is keep his fluid levels low. He takes 120 mg. of diueretic, and does a low salt diet. You might find that your condition can be managed medically for awhile. They will not rush into surgery.

I wish you the very best, and if you find any other links that could be helpful, please let me know. - Marybeth

 

[bvdr]

Marybeth, you may be very right about pulmonary hypertension not being the cause of the problems but a byproduct of other problems. Nevertheless, high pressures in the pulmonary artery do indicate the presence of pulmonary hypertension and will lead to damage. If possible it needs to be corrected.

 

[Nancy]

My husband has a severely leaking tricuspid. It's been leaking since at least 1999. He also had two valve replacements, both mechanical, the aortic and the mitral.

Although many cardiologists and even a surgeon have known about the tricuspid and have even tested it, and I would guess looked at it during mitral valve replacement, no one wants to do anything about it.

His recent echoes and a right and left heart cath show some improvement in his overall heart pressures.

He also has pulmonary hypertension which two and a half years ago was severe (pressures in the mid-high 70s). He was put on Tracleer, and his pressures are much lower now (pressures 44 at the highest by right heart cath). It was extremely important to his overall health to get his pulmonary hypertension under control. Even at lower pressures, there are several medications that can be used.

He has right-sided heart failure which can get difficult to manage at times. Right now, he is on three diuretics and just got out of the hospital for CHF which wouldn't go away at home.

His regimen is very strict at home, a very low sodium diet 500mg or less, daily weigh-ins and his diuretics.

Because he has had three valve surgeries, the two valve replacements and a repair on his mitral, all cardiologists have agreed that at this point he is almost inoperable. To do another valve surgery there would have to be extremely strong indications for surgery.

All have agreed also that his symptoms possibly related to tricuspid regurgitation, can be controlled medically for the present time. And he is followed very closely by several doctors.

I am not sure at what level tricuspid repair or replacement is recommended, but I do know that a lot of times doctors will not rush in to do surgery on this valve, and will try to control symptoms with medications and diet.

I am sure your symptoms and any worsening conditions will prompt a review of your surgical status. If you are finding yourself increasingly debillitated, push for some answers.

 

[Georgia]

Hi, Lynn.

I had my tricuspid valve repaired when the mitral was replaced. The mitral was so bad that for me the tricuspid was certainly secondary, altho I had distended carotid arteries from the tricuspid problem.

I don't know that there's any more information I can give you; but repairs to the tricuspid (I have the "ring" - annulus) are common and seem to take really well (I guess there's less pressure in the tricuspid).