Risk factors for tricuspid valve regurgitation after orthotopic heart transplantation

Donor Tricuspid Annuloplasty During Orthotopic Heart Transplantation: Long-Term Results of a Prospective Controlled Study

“…This difference is attributed to alteration in the geometry of the tricuspid valve and right atrium related to the technique of right atrial anastomosis. Other possible causes of TR include: 1) allograft dysfunction with right ventricular dilatation due to poor preservation, reperfusion injury, donor factors, or rejection, 2) pulmonary hypertension, 3) severe donor recipient size mismatch, and 4) structural damage occurring during endomyocardial biopsy [6,7,8,9,10].…”

Echo-guided endomyocardial biopsy in heart transplant recipients

“…Under careful echocardiographic monitoring ventricular perforation can be avoided and developing haemopericardium or tamponade can be diagnosed at an early stage. Higher grades of tricuspid regurgitation in the post-transplant period are related to the classic surgical technique (Shumway), to the number of rejection episodes and to the number of EMBs performed [23,24,25,263. In this respect the echo-guided EMB is clearly superior to the X-ray technique, as the bioptome forceps and its relation to the tricuspid apparatus can be easily monitored by echocardiography.…”

Influence of different implantation techniques on AV valve competence after orthotopic heart transplantation

“…The chordae tendineae usually arise from the papillary muscles but also from the septal wall and thus are subject to trauma by the biotome each time it traverses the tricuspid valve [8,24]. The influence of number and degree of rejection episodes on the incidence of TR is discussed controversely [2,8]. Especially in the late postoperative period the recipients in our institution developed moderate and severe tricuspid insuffiency if they were transplanted in the standard technique.…”

“…The total orthotopic transplantation technique is currently used in only 4.5% of centres performing heart transplantation worldwide [2]. A total number of 166 patients in two different implantation groups has been followed up for 7 years and were echocardiographically examined on the presence of mitraland tricuspid-insufficiency and left atrial size.…”