Practical Manual of Tricuspid Valve Diseases

Description

​This book provides a comprehensive overview of tricuspid valve disease and an overview of different therapeutic options such as surgical and percutaneous approaches, current clinical trials and registries in the field of tricuspid valve disease. The book has an educational goal with key messages highlighted at the end of each chapter to assist comprehension of the often complex concepts. Practical Manual of Tricuspid Valve Diseases assists the clinician in dealing with different manifestations of tricuspid valve disease and providing help for choosing the best option for the management of these patients. It therefore serves as the standard reference regarding all aspects of tricuspid valve disease in adults and will be of importance to all medical professionals involved in the management of these patients.

Table of Contents

1. Part I: Anatomical and Pathological Perspective
2. Chapter 1: Anatomy and Pathology of the Tricuspid Valve
3. Components of the Tricuspid Valve
4. The Tricuspid Leaflets and Commissures
5. Tendinous Cords and Papillary Muscles
6. Pathological Changes in the Tricuspid Valve
7. The Tricuspid Valve in Disease
8. Tricuspid Regurgitation
9. Valvar Stenosis
10. Straddling Tricuspid Valve
11. Conclusion
12. Take Home Points
13. Review Questions
14. References
15. Part II: Clinical Perspective
16. Chapter 2: Clinical Recognition of Tricuspid Valve Disease
17. Tricuspid Stenosis
18. Frequency [2]
19. Natural History
20. Clinical Features
21. Common Symptoms
22. Less Common Symptoms
23. Rare Symptoms
24. Aetiology and Pathogenesis
25. Rheumatic Heart Disease
26. Congenital Tricuspid Stenosis
27. Infective Endocarditis
28. Carcinoid Heart Disease
29. Unusual Causes
30. Differential Diagnosis
31. Investigations
32. Management
33. Consultations
34. Tricuspid Regurgitation
35. Pathophysiology
36. Physical Examination
37. Differential Diagnosis
38. Investigations
39. Natural History and Prognosis
40. Medical Therapy
41. Long-Term Monitoring
42. Approach Considerations
43. Specific Conditions
44. Tricuspid Atresia
45. Presentation
46. Investigations
47. Management
48. Complications
49. Prognosis
50. Review Questions
51. Select the Single Best Answer
52. Case Studies
53. References
54. Chapter 3: Tricuspid Regurgitation in Patients with Heart Transplant
55. Introduction
56. Case
57. Epidemiology
58. Pathophysiology
59. Clinical Features
60. Management and Prognosis
61. Key Points
62. Review Questions
63. Select the Single Best Sentence
64. References
65. Chapter 4: Tricuspid Regurgitation in Patients with Pacemakers and Implantable Cardiac Defibrilla
66. Introduction
67. Pathophysiology and Mechanisms (See Fig. 4.1)
68. Clinical Presentation
69. Imaging
70. Management (See Fig. 4.4)
71. Prevention (See Table 4.2)
72. Summary
73. Review Questions
74. References
75. Part III: Non-invasive Imaging Perspective
76. Chapter 5: Tricuspid Valve Disease: Imaging Using Transthoracic Echocardiography
77. Introduction
78. Tricuspid Valve Apparatus
79. TTE Examination of the Tricuspid Valve
80. TTE Modes
81. 2D–TTE
82. 3D-TTE
83. Acquisition
84. Analysis and Display
85. Incremental Value of 3D-TTE over 2D-TTE of the TV
86. Simultaneous Multiplane Imaging
87. Bi-plane TTE
88. iRotate Mode
89. TTE Approach to Tricuspid Valve Disease
90. TTE Approach to Tricuspid Valve Stenosis
91. TTE Approach to Tricuspid Valve Regurgitation
92. TTE Diagnostic Algorithm of TR
93. Etiology and Mechanisms of TR
94. Grading of TR Severity
95. Use of Colour Doppler in TR Severity Assessment
96. TR Jet Area
97. TR Jet Vena Contracta
98. Flow convergence method (proximal isovelocity surface area [PISA] method). Flow Acceleration and T
99. Method 1. PISA Quantification of TR
100. Method 2. PISA Quantification of TR
101. Caveats in PISA Estimation of TR
102. PISA Quantification on 3DE
103. TR Jet on Continuous-Wave Doppler
104. Hepatic Vein Flow in Patients with TR
105. Other Surrogate Signs of TR Severity
106. Assessment of TR Severity in Functional TR (Special Considerations)
107. TTE Assessment of the Tricuspid Valve Annulus
108. Key Points
109. Review Questions
110. Select the Single Best Sentence
111. References
112. Chapter 6: Imaging of the Tricuspid Valve: Transoesophageal Echocardiography
113. Introduction
114. TOE Imaging for Tricuspid Valve Imaging
115. Grading Severity of Tricuspid Regurgitation
116. Review Questions
117. Select the Single Best Sentence
118. References
119. Chapter 7: A Surgeon’s View on Echocardiographic Imaging of the Tricuspid Valve
120. Introduction
121. Tricuspid Annulus
122. Degree of Tricuspid Regurgitation
123. Morphology
124. Tethering
125. Case 1: Functional Tricuspid Regurgitation with a Structural Component
126. Heart Team Evaluation
127. Operation
128. Postoperative Period
129. Case 2: Cardiac Endovascular Pacemaker-Lead Interference of the Tricuspid Valve
130. Heart Team Evaluation
131. Operation
132. Postoperative Period
133. Case 3: Functional Regurgitation Due to Left Sided Heart Disease
134. Heart Team Evaluation
135. Operation
136. Postoperative Period
137. Discussion
138. Take Home Message
139. Review Questions
140. References
141. Chapter 8: Imaging of the Tricuspid Valve: Magnetic Resonance Imaging
142. Introduction
143. TV Anatomy
144. Comprehensive Evaluation of Tricuspid Valve by CMR
145. Assessment of Tricuspid Valve Anatomy
146. CMR Sequence and Image Acquisition
147. Advantages
148. Limitations
149. Assessment of Tricuspid Valve Flow
150. CMR Sequence and Image Acquisition
151. Assessment of Right Ventricle Volume and Function
152. CMR Sequence and Image Acquisition
153. Assessment of Myocardial Fibrosis
154. CMR Sequence and Image Acquisition
155. Limitations
156. Classification of TV Dysfunction
157. Tricuspid Valve Regurgitation
158. Secondary Tricuspid Valve Regurgitation
159. Primary Tricuspid Valve Regurgitation
160. Tricuspid Valve Stenosis
161. CMR Imaging for Secondary Tricuspid Valve Regurgitation
162. CMR Imaging for Primary Tricuspid Valve Regurgitation
163. Ebstein’s Anomaly
164. Rheumatic Heart Disease
165. Infective Endocarditis
166. Carcinoid Syndrome
167. Tumors
168. Traumatic
169. CMR Imaging for Tricuspid Stenosis (TS)
170. Conclusion
171. Review Questions
172. Select the Single Best Sentence
173. References
174. Chapter 9: Tricuspid Valve Disease: A Computed Tomographic Assessment
175. Imaging Technics of the Tricuspid Valve Using CT
176. Scan Mode
177. Contrast Injection
178. Clinical Utility of Computed Tomography in Right Heart Diseases
179. Computed Tomography Acquisition Techniques for the Right Side of the Heart
180. Clinical Utility of Cardiac CT
181. Comprehensive Assessment of Tricuspid Valve and Surrounding Structures by CT
182. The Tricuspid Valve
183. Tricuspid Annulus
184. CT Assessment of the Tricuspid Valve and Adjacent Anatomical Structures
185. Advantages
186. Limitations
187. The Right Coronary Artery
188. The Right Ventricular Apex
189. The Vena Cava
190. Surgical Interventions for the Tricuspid Valve
191. Clinical Utility of CT in Planning Transcatheter Interventions for Functional TR
192. Percutaneous Tricuspid Annuloplasty
193. Tricuspid Orifice
194. Caval Valve Implantation Concept
195. Conclusion
196. Appendix
197. Review Questions
198. Select the Single Best Sentence
199. References
200. Chapter 10: Tricuspid Annulus Measurements: Dynamic Changes in Health and Disease
201. Introduction
202. Normal Tricuspid Annulus: Size, Shape and Dynamics
203. Changes in Tricuspid Annulus Geometry and Function in Functional Tricuspid Regurgitation
204. Measurement of Tricuspid Annulus Dilation
205. Tricuspid Annulus Deformation: A “New” Pathophysiologic Entity for TR Development?
206. Unmet Needs and Future Research Directions
207. Conclusions
208. Review Questions
209. Select the Single Best Sentence
210. References
211. Chapter 11: Imaging of the Right Ventricle: Overview of Imaging Modalities for Assessing RV Volu
212. Introduction
213. Right Ventricular Anatomy and Physiology
214. Imaging Modalities for Assessment of RV Function and Size, and Tricuspid Annulus Size
215. Echocardiography
216. RV Function
217. Right Ventricular Size
218. Cardiovascular Magnetic Resonance
219. Multidetector Computed Tomography (MDCT)
220. Radionuclide Techniques
221. Summary
222. References
223. Part IV: Hemodynamic Perspective
224. Chapter 12: Echocardiographic Assessment of Pulmonary Artery Pressure, Tips and Tricks
225. Introduction
226. The Anatomy of the Right Ventricle and the Effects of Elevated Pulmonary Arterial Pressures
227. Parasternal Long Axis View of the Left Ventricle
228. Parasternal Long Axis of the Right Ventricle
229. Parasternal Long and Short Axis Views of the Pulmonary Valve and Main Pulmonary Artery
230. Parasternal Short Axis at the Level of the Papillary Muscles
231. Apical 4 Chamber View
232. Tricuspid Valve Anatomy and Effect of High Pulmonary Artery Pressures and Right Ventricle Dilata
233. Pulmonary Pressure Estimation
234. Pulmonary Artery Pressure Estimation Using Tricuspid Valve Regurgitation
235. Pulmonary Artery Pressure Estimation Using Pulmonary Valve Regurgitation
236. Pulmonary Artery Pressure Estimation Using the Right Ventricle Outflow Pulsed Wave Doppler Velocit
237. Pulmonary Artery Diameter
238. Questions
239. Review Questions
240. References
241. Chapter 13: Right Heart Catheterization for Hemodynamic Evaluation of Right Sided Heart Disease
242. Introduction
243. Basics of the Right Heart Catheterization
244. Tips and Tricks
245. Hemodynamic Information from a RHC
246. Calculation of Cardiac Output
247. Assessment and Calculation of Intra-Cardiac Shunts
248. Resistance of the Vascular Bed
249. Conclusion
250. Review Questions
251. References
252. Part V: Therapeutic Perspective
253. Chapter 14: Pharmacotherapy of Tricuspid Valve Disease
254. Introduction
255. Case
256. Pharmacotherapy (See Fig. 14.3)
257. Lifestyle Advises
258. Loop Diuretics
259. Mineralocorticoid Receptor Antagonist
260. Digoxin
261. ACE-Inhibitors, Angiotensin II Receptor Blocker and Beta-Blockers
262. References
263. Chapter 15: Tricuspid Valve Interventions: Heart Team Discussion, When, Who and What?
264. Prevalence and Mechanism of Tricuspid Regurgitation
265. Outcomes
266. Surgery for TR
267. Transcatheter Interventions for TR
268. Imaging of the Tricuspid Valve
269. Transthoracic Echocardiography
270. Transesophageal Echocardiography
271. Transcatheter Treatment Modalities
272. Bicaval Valve Implantation
273. Devices to Improve Leaflet Apposition
274. Annuloplasty Devices
275. Preclinical Experience with Upcoming Devices
276. Transcatheter Valve Replacement
277. Conclusions
278. References
279. Chapter 16: Tricuspid Valve Disease: Surgical Outcome
280. Introduction
281. Tricuspid valve Repair and Replacement
282. Tricuspid Valve Repair
283. Patient Presentation and Intraoperative Details
284. Outcomes
285. Tricuspid Valve Replacement
286. Patient Presentation and Intraoperative Details
287. Outcome
288. Outcomes of Bioprosthesis vs. Mechanical Prosthesis
289. Functional Tricuspid Regurgitation
290. Patient Presentation and Intraoperative Details
291. Outcome
292. Rheumatic Tricuspid Valve Disease
293. Patient Presentation and Intraoperative Details
294. Outcomes
295. Congenital Tricuspid Valve Disease
296. Patient Presentation and Intraoperative Details
297. Outcome
298. Carcinoid Disease of the Tricuspid Valve
299. Iatrogenic Damage of the Tricuspid Valve
300. Endocarditis of the Tricuspid Valve
301. Take Home Message
302. Review Questions
303. References
304. Chapter 17: Tricuspid Valve Disease: Surgical Techniques
305. Preparation for Cardio-Pulmonary Bypass
306. Access
307. Cannulation
308. Exposure
309. Surgical Anatomy and Analysis
310. Tricuspid Valve Repair for Functional Disease
311. Suture Annuloplasty
312. Kay Procedure
313. De Vega Procedure
314. Ring Annuloplasty
315. Enlargement of the Anterior Leaflet
316. “Clover Technique”
317. Results
318. Tricuspid Valve Repair for Primary Disease
319. Intervention on the Leaflets
320. Intervention on the Chordae
321. Intervention on the Papillary Muscles
322. Intervention on the Commissures
323. Tricuspid Valve Replacement
324. Choice of the Prosthetic Valve
325. Surgical Technique
326. Results
327. Special Condition
328. Tricuspid Valve Endocarditis
329. Ebstein’s Anomaly
330. Carcinoid Disease
331. Traumatic Lesion
332. Pacemaker Lead-Induced Tricuspid Regurgitation
333. Late Tricuspid Regurgitation Following Previous Left-Sided Valve Surgery
334. Case Report
335. References
336. Chapter 18: Transcatheter Interventions for Tricuspid Regurgitation: Rationale, Overview of Curren
337. Rationale for Transcatheter Interventions for Tricuspid Regurgitation
338. Anatomical Challenges to Transcatheter Tricuspid Valve Interventions
339. Approaches for Transcatheter Tricuspid Valve Interventions
340. Orthotopic Valve Implantation
341. Native Tricuspid Valve Replacement
342. Dedicated Transcatheter TV Bioprosthesis
343. Non-Dedicated Transcatheter Heart Valve Implantation in the Tricuspid Position
344. Transcatheter Valve in Malfunctioning Surgical Bioprosthetic Valve
345. Transcatheter Valve in Tricuspid Repair Ring
346. Heterotopic (Vena Caval) Valve Implantation
347. Self-Expanding (Dedicated) Valve
348. Balloon-Expandable Transcatheter Heart Valves
349. Transcatheter Tricuspid Valve Repair
350. Annular Reduction/Remodeling Devices
351. The Mitralign/Trialign Device
352. The TriCinch System
353. The Transatrial Intrapericardial Tricuspid Annuloplasty (TRAIPTA) Device
354. Surgical-Like Annuloplasty Rings
355. Coaptation Devices
356. The FORMA Repair System and the TV Occluder Device
357. The MitraClip Device
358. Open Issues and Future Perspective
359. Safety Issues
360. Preprocedural Planning and Procedural Guidance
361. What Efficacy Endpoints are Suitable for TTVIs Studies?
362. References
363. Chapter 19: Catheter-Based Therapy for Tricuspid Valve Disease: Practical Considerations for Interve
364. Introduction
365. Patients’ Selection: Which Patient Could Benefit the Most from Interventional Tricuspid Therapi
366. Anatomical Considerations
367. The Importance of Imaging: Patients’ Eligibility and Intraprocedural Guidance
368. Specific Considerations for Transcatheter Tricuspid Valve in Valve and Valve in Ring
369. Specific Considerations for Transcatheter Tricuspid Valve Repair Devices
370. Tricuspid Clipping
371. Tricuspid Annuloplasy Devices
372. Caval Valve Implantation
373. Pericardial Device
374. Tricuspid Valve Spacer
375. How to Report the Outcome?
376. Conclusions
377. Review Questions for Chapters 15, 18 and 19
378. Select the Single Best Sentence
379. Answers
380. References
381. Index

Editors Biography

Dr Osama I. Soliman, MD, PhD, FACC, FESC works as assistant professor of cardiology at the Thoraxcenter, Erasmus MC: University Medical Center Rotterdam, Rotterdam, the Netherlands. He is the director of structural heart imaging at Cardialysis, Rotterdam, The Netherlands. Dr Soliman is a consultant cardiologist specialised in non-invasive cardiovascular imaging and he is a principal investigator of several clinical trials.

Dr Soliman has been graduated in 1996 Summa Cum Laude from the Medical School of Al-Azhar University, Cairo, Egypt. He completed eight years of training in internal medicine and cardiology at Al-Azhar University Hospitals in Cairo, Egypt. In 2000, he was awarded the degree of Master of Science Cum Laude based on a dissertation entitled “Intravascular ultrasound versus quantitative coronary angiography for the assessment of immediate results of coronary artery stenting”. In 2005, he joined the Thoraxcenter, Erasmus MC:University Medical Center Rotterdam, Rotterdam, the Netherlands where he was granted the doctoral degree from the Erasmus University Rotterdam, the Netherlands in 2007 based on dissertation entitled “Advanced quantitative echocardiography guiding therapy for heart failure”.

His major areas of teaching and research include echocardiography and non-invasive imaging and heart failure. He is leading a research team in structural heart interventions and outcome studies. His bibliography to date includes more than 200 articles and book chapters.

Dr. Soliman is an active member of several professional societies and organizations including the American College of Cardiology, the European Society of Cardiology, the American Society of Echocardiography, the International Society of Contrast Ultrasound. He is a member of the Editorial Board of several prestigious cardiology journals including the Journal of the American Society of Echocardiography and Eurointervention.

Dr Folkert J. ten Cate MD, PhD, FESC, FACC is an Associate Professor of the Department of Cardiology at the Thoraxcenter, Erasmus MC: University Medical Center Rotterdam, Rotterdam, the Netherlands. He has been the late director of the Thoraxcenter fellow training program. Dr ten Cate is a consultant cardiologist specialised in general cardiology and non-invasive cardiovascular imaging.

Dr ten Cate has been graduated in 1972 from the Medical School of Erasmus University, Rotterdam, The Netherlands. He completed six years of training in internal medicine and cardiology at Erasmus University Hospitals in Rotterdam, The Netherlands. In 1973, he joined the Erasmus MC: University Medical Center Rotterdam, Rotterdam, the Netherlands, where he was granted the doctoral degree from the Erasmus University Rotterdam in 1978 based on a dissertation entitled “Asymmetric septal hypertrophy (ASH): echocardiographic manifestations dissertation”.

He has given numerous international and national lectures. He is a world renown expert in Hypertrophic Cardiomyopathy and Contrast Echocardiography. Also he has trained numerous foreign and national fellows in cardiology.
His major areas of teaching and research include echocardiography and non-invasive imaging, cardiomyopathies, valvular heart disease, and diastolic heart failure. His bibliography to date includes more than 350 articles and book chapters.

Dr. ten Cate is an active member of several professional societies and organizations including the American College of Cardiology, the European Society of Cardiology and the International Society of Contrast Ultrasound.