<![CDATA[<B>Proportion among the segments of the normal tricuspid valve annulus</B>: <B>parameter for valve annuloplasty</B>]]>

Abstract

Proporção entre os segmentos do anel da valva tricúspide normal: um parâmetro para realização da anuloplastia valvar

Special Measures to Do De Vega Procedure

“…Antoniali and colleagues [3] studied 30 normal tricuspid valves from cadavers without fixation and they measured each cuspid. They found that the septal segment of tricuspid valves occupied 29.5% of the ring, while the anteroposterior segment was 70.5%, providing a ratio of 1:2.43.…”

“…There is growing evidence that in patients with a bicuspid aortic valve (BAV), the transvalvular hemodynamics, especially aortic insufficiency, are associated with the AA phenotype and risk of aTAd [3,4]. The patient's age is also important: eg, a 20-year-old man with a 4.5-cm AD is more than 7 z score values apart from his expected age-adjusted, gender-adjusted, and body surface area-adjusted AA diameters, indicating a highly pathologic process!…”

“…Inasmuch as most patients with BAV lesions requiring surgical repair have ADs of 5 cm or less, and additional AA replacement adds minimal risk to the valve procedure, the decision for prophylactic replacement of the AA must include more refined predictors, such as age; body surface area; family history; growth rate; hemodynamics, especially insufficiency; ascending aorta and BAV phenotypes; and quality of the wall tissue [3]. The time is ripe for a more individual treatment than that dictated by generalized AA cutoff recommendations.…”