title: Isolated severe tricuspid regurgitation in a post pneumonectomy patient with chronic atrial fibrillation.
abstract: Severe primary tricuspid regurgitation is a rare entity, with most cases of tricuspid regurgitation being functional and secondary to pulmonary hypertension from left heart pathologies. We report an unusual case of a female patient with a history of left pneumonectomy and chronic atrial fibrillation many years earlier, and who subsequently developed tricuspid annular dilatation, resulting in severe isolated primary tricuspid regurgitation despite normal pulmonary artery pressures and left ventricular systolic function. She required multiple hospitalizations for right heart failure and continued to be NYHA class IV despite receiving maximal medical management. She finally underwent an isolated tricuspid valve ring annuloplasty, which gave her symptomatic relief. Postoperatively, she improved to NYHA class 1-II still with chronic atrial fibrillation and mild to moderate tricuspid regurgitation at the time of her death 9 years later from pneumonia.
authors.affiliation: Section of Cardiothoracic Surgery, Atlanta Medical Center, Atlanta, Georgia 30312, USA. Jnwiloh@gtcvsurg.com
authors.forename: Jonathan O
authors.initials: JO
authors.lastname: Nwiloh
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D001794:Blood Pressure; D058385:Cardiac Valve Annuloplasty; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000209:etiology; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011651:Pulmonary Artery / Q000503:physiopathology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D016277:Ventricular Function, Left