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

 

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

 

severity of TR criteria

 

normal RV systolic function criteria

 

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

exercise testing

- indication exercise testing

indication exercise testing

- severe TR with no or minimal symptoms

treatment

- medication

- surgery

 

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

 

indication TV repair

- mild to moderate functional TR with left-sided valve surgery with ...

 

indication tricuspid annuloplasty

- symptomatic severe primary TR

- mild to moderate TR with pulmonary hypertension or tricuspid annular dilatation

 

indication TVR

- severe TR not amendable to annuloplasty or repair

 

surgical technique

- bicuspidization

- DeVega suture annuloplasty

- Carpentier ring annuloplasty

follow up

- f/u ในคนไข้ TR อย่างไร

f/u ในคนไข้ TR อย่างไร