TY -的A2 Kivelitz迪盟——德阿西斯说,亚瑟Cicupira罗德里格斯AU -米德尔斯堡,Gustavo Andre波音AU - Demarchi Lea玛丽亚Macruz费雷拉盟——Scudeler蒂亚戈Luis AU - Rezende保罗卷曲PY - 2021 DA - 2021/09/13 TI -诊断管理和手术治疗孤立的三尖瓣返流SP - 9928811六世- 2021 AB -重度三尖瓣返流尤其引起肺动脉高压。初级三尖瓣返流没有肺动脉高压病因不明的是一种非常罕见的疾病和稀缺的数据对其诊断、治疗和随访。手术适应症的特性和结果还不清楚。一个72岁的女人病史的冠状动脉旁路移植三年前出现气短和低肢体水肿。体检显示突出双边颈静脉肿胀,肝肿大,周边水肿,和左midsternal边界全收缩期的杂音,暗示了三尖瓣返流。超声心动图证实了诊断和显示保存左、右心室维度和函数。冠状动脉造影显示没有新的阻塞性病变和专利外科移植。右心导管检查显示轻度肺动脉高压和右心房压力增加。心脏磁共振显示轻度右心室扩张与正常收缩功能和正常左室。没有检测到晚钆增强。 Because of persistent symptoms, even after optimization of medical therapy, the patient was submitted to tricuspid valve replacement surgery. Immediately after the surgery, the patient developed significant right ventricular dysfunction, with the need of continuous hemodynamic support. She had progressive clinical recovery that was confirmed by serial echocardiograms that showed improvement in right ventricular volume and function. The patient was discharged with no signs or symptoms of right heart failure. The histopathological examination showed significant and diffuse myxomatous degeneration of the leaflets. No signs of infection or vegetation nor disruption of strands were observed. This report illustrates a very rare case of symptomatic primary isolated severe tricuspid regurgitation caused by myxomatous degeneration of the leaflets. The thoroughly diagnostic workup is presented, and only the histopathological analysis of the leaflets revealed the etiologic process. Surgical treatment indicated before the onset of right ventricular failure was essential to patient’s full recovery. SN - 2090-6404 UR - https://doi.org/10.1155/2021/9928811 DO - 10.1155/2021/9928811 JF - Case Reports in Cardiology PB - Hindawi KW - ER -