tricuspid regurgitation | |
classification - etiologhy of TR |
etiology of TR - organic TR (primary cause) - functional TR (secondary cause) |
pathogenesis - pathogenesis of TR in mitral valve disease |
pathogenesis of TR in mitral valve disease |
investigation - CXR - EKG - echocardiography - cardiac catheterization - exercis testing |
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echocardiography - parameter ที่ใช้ในการดูใน echocardiography - severity of TR - severity of TR criteria - normal RV systolic function criteria - criteria echocardiography for severe TR |
parameter ที่ใช้ในการดูใน echocardiography - central jet area - vena contracta width - CW jet density and contour - hepatic vein flow : systolic reversal |
severity of TR - A = at risk of TR - B = progressive TR - C = asymptomatic severe TR - D = symptomatic severe TR |
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severity of TR criteria |
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normal RV systolic function criteria |
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criteria echocardiography for severe TR - severe TR criteria ** vena contracta width ** proximal isovelocity surface area (PISA) radius ** systolic flow reversal in the hepatic veins ** dilatation of the RV, RA, IVC - functional TR |
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exercise testing - indication exercise testing |
indication exercise testing - severe TR with no or minimal symptoms |
treatment - medication - surgery |
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surgery - indication surgery - กลุ่มโรคใดบ้างที่ควรได้รับการผ่าตัด - indication TV repair - indication tricuspid annuloplasty - indication TVR - surgical technique |
indication surgery - mild to moderate TR wtih ** annular dilatation ** recent sign of right heart failure (pulmonary hypertension) - asymptomatic severe primary or secondary TR with ** undergoing mitral or multi-valve surgery ** progressive RV dilatation or dysfunction - symptomatic severe primary or secondary TR ** unresponsive to medical therapy |
กลุ่มโรคใดบ้างที่ควรได้รับการผ่าตัด |
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indication TV repair - mild to moderate functional TR with left-sided valve surgery with ... |
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indication tricuspid annuloplasty - symptomatic severe primary TR - mild to moderate TR with pulmonary hypertension or tricuspid annular dilatation |
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indication TVR - severe TR not amendable to annuloplasty or repair |
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surgical technique - bicuspidization - DeVega suture annuloplasty - Carpentier ring annuloplasty |
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follow up - f/u ในคนไข้ TR อย่างไร |
f/u ในคนไข้ TR อย่างไร |