title: Recurrent bilateral varicose veins secondary to tricuspid regurgitation.
abstract: BACKGROUND
  Varicose veins are a common condition. We present a case of recurrent veins due to tricuspid regurgitation.
  
  
  METHODS
  A 55-year-old female presented with large bilateral varicosities. On examination these were extensive and pulsatile in nature over both legs. Three and 5 years previously she presented with similar signs and had undergone bilateral venous surgery including Trendelenburg procedure. Past medical history included successful atrial septal defect repair in 1995. Severe tricuspid regurgitation and right heart failure was diagnosed in 2000, followed by annuloplasty 2 years later. Prior to attempting venous surgery the third time an echocardiogram was performed. This demonstrated severe tricuspid regurgitation again and therefore surgery was not undertaken at this time.
  
  
  CONCLUSIONS
  Concurrent valvular disease should be fully investigated and optimised before consideration is given to surgery, with a multidisciplinary approach being essential in its management.
authors: Department of Vascular and Endovascular Surgery, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, UK. stephenbadger@btinternet.com
authors: S A
authors: SA
authors: Badger
authors: R R
authors: RR
authors: Makar
authors: E W
authors: EW
authors: Chew
authors: B
authors: B
authors: Lee
mesh_terms: D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D014262:Tricuspid Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging; D014648:Varicose Veins / Q000209:etiology* / Q000601:surgery