The letter T shows the position of the tricuspid valve in the heart
In tricuspid valve stenosis there is restriction of valve opening thereby making it difficult for blood to flow through the heart
DIAGNOSES-OPERATIONS
 

TRICUSPID VALVE STENOSIS

The revolution in heart valve operations has come from the advent of the Heart Team, a group of specialized physicians dealing with all aspects of the heart – cardiac surgeons, interventional cardiologists, echocardiographers, cardiac anesthesiologists, vascular surgeons and cardiac radiologists.  This team analyzes all of the patients data and recommends a solution that is customized for the specific patient.  The heart team at HYGEIA Hospital is one of the few teams worldwide that performs operations that are cutting-edge, oftentimes with technology that is not available to all physicians (in the setting of a clinical trial).  This gives us the opportunity to provide solutions for patients who have been told that they are inoperable. 

Of paramount importance is the unique Hybrid Operating Room at HYGEIA Hospital which is the first in Greece. The Hybrid Operating Room is an operating room of the highest technological specifications which is modified to be able to carry out both classic “open” operations as well as endovascular and transcatheter operations which are performed with a simple needlestick and without any incisions.  

Dr. Pattakos is the co-organizer of the well-known conference “Transcatheter Heart Valves Greece” which is attended by international experts in cardiology and cardiac surgery to discuss the latest developments regarding heart valves.  For further information please visit www.thvgreece.com

VALVE REPAIR OR VALVE REPLACEMENT?
Heart valve operations are divided into those which repair the valve and those which replace the valve if it cannot be repaired.  The anatomic characteristics of each valve help the surgeon decide which of the two choices is best for each patient.

SELECTION OF MECHANICAL OR BIOLOGICAL VALVE
For patients who require a valve replacement there is a choice to be made about whether to receive a mechanical (also known as metallic) valve or a biological valve. 
A mechanical valve can function for multiple decades but the drawback is that patients require blood thinners.  The patient who takes these blood thinners requires frequent laboratory evaluation of their levels.  They must also eat stable quantities of foods that contain Vitamin K as this vitamin influences the clotting process. There is also an estimated 1-2% risk of clotting of the valve or bleeding anywhere in the body.

Biological valves do not require blood thinners but they have an approximately ten year lifespan (longer for older patients and shorter for younger patients). When the valve starts to dysfunction this usually happens gradually and patients perceive symptoms and must usually receive a second operation.  This second operation can be performed either with open surgery or, in some cases, with a catheter using a small puncture in the groin.  

WHAT IS IT?
The tricuspid valve sits between the right atrium (where blood returning from the body is first received into the heart) and the right ventricle which will pump the blood towards the lungs so it can receive oxygen.  In tricuspid valve stenosis the passage through the valve has become narrowed thereby making it more difficult for blood to return towards the heart and proceed towards the lungs. 

WHAT ARE THE CAUSES?
In most cases tricuspid valve stenosis is due to rheumatic fever which comes from a prior streptococcal infection. In rare circumstances it may be due to other causes such as radiation therapy or carcinoid tumor which secretes certain chemicals that affect the valve. 

SYMPTOMS
Common symptoms include easy fatigue, abdominal pain, abdominal swelling especially near the liver, and swollen legs.  

OPERATION
In most cases the valve will require replacement because the valve tissue has become destroyed. Replacement may be done with a minimally invasive approach (thoracoscopic, endoscopic, robotic).  The decision must be made between a biological valve which is usually preferred, or a mechanical valve.
Attending Surgeon 2nd Department of Cardiac Surgery
Assistant Director Division of Transcatheter Heart Valves
HYGEIA HOSPITAL

Erithrou Stavrou 4, Marousi
210 6867639, 210 6867640
gregpattakos@yahoo.com
FOLLOW US
© 2020 Gregory Pattakos. All rights reserved.