title: Advanced mitral-tricuspid disease with severe right ventricular dysfunction: the double-staged approach.
abstract: Tricuspid valve surgery in the presence of severe right ventricular dysfunction and pulmonary hypertension secondary to mitral valve stenosis is associated with poor early outcomes. We report the case of a young patient, presenting with severe chronic mitral-tricuspid disease responsible for long-lasting pulmonary hypertension and altered right ventricular function, who initially underwent mitral valve replacement and 7 days later the correction of her tricuspid insufficiency. This 2-staged approach permitted progressive reduction of pulmonary pressure and partial right ventricular remodeling before closing the systolic release valve of the right ventricle represented by tricuspid regurgitation.
authors.affiliation: Department of Cardiovascular Surgery, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou and Université Paris-Descartes, Sorbonne Paris Cité, Paris, France. jouanjerome@hotmail.com
authors.forename: Jérôme
authors.initials: J
authors.lastname: Jouan
authors.forename: Paul
authors.initials: P
authors.lastname: Achouh
authors.forename: Laila
authors.initials: L
authors.lastname: Besson
authors.forename: Alain
authors.initials: A
authors.lastname: Carpentier
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Fabiani
mesh_terms: D000328:Adult; D001705:Bioprosthesis; D002908:Chronic Disease; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008943:Mitral Valve / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012214:Rheumatic Heart Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D018570:Risk Assessment; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D020257:Ventricular Remodeling / Q000502:physiology*