The pivotal role of tricuspid regurgitation in the failing systemic right ventricle: The "chicken and egg story"

被引:4
作者
Silni, Alexandre [1 ,4 ,5 ]
Avesani, Martin [1 ,4 ,5 ]
Houyel, Lucile [2 ,3 ]
Thambo, Jean-Benoit [1 ,4 ,5 ]
Iriart, Xavier [1 ,4 ,5 ,6 ]
机构
[1] Univ Hosp Bordeaux, Dept Pediat & Adult Congenital Cardiol, Bordeaux, France
[2] M3C Enfants Malad Hosp, AP HP, Dept Congenital & Pediat Cardiol, Paris, France
[3] Univ Paris Cite, Paris, France
[4] Fdn Bordeaux Univ, Electrophysiol & HeartModeling Inst, IHU Liryc, Bordeaux, France
[5] Ctr Rech Cardio Thorac Bordeaux, Inserm, Bordeaux, France
[6] CHU Bordeaux Hop Haut Leveque, Serv Cardiopathie Congenitale, Ave Magellan, F-33600 Pessac, France
关键词
Systemic right ventricle; Tricuspid regurgitation; Transposition of the great arteries; Congenitally corrected transposition of the great arteries; Hypoplastic left heart syndrome; CONGENITALLY CORRECTED-TRANSPOSITION; LEFT-HEART SYNDROME; ATRIOVENTRICULAR VALVE-REPLACEMENT; GREAT-ARTERIES; ATRIAL SWITCH; MAGNETIC-RESONANCE; SYSTOLIC FUNCTION; RESYNCHRONIZATION THERAPY; CLINICAL CHARACTERISTICS; PATHOLOGICAL ANATOMY;
D O I
10.1016/j.acvd.2022.05.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Systemic right ventricle (SRV) is commonly encountered in patients with congenital heart disease. This nomenclature includes diseases with different anatomic features, adaptation and clinical phenotypes, and has a variable - but overall guarded - prognosis. Right ventricular fibromuscular architecture, shape, adaptation to overload conditions, rhythmic disorders and - most of all - tricuspid regurgitation (TR) contribute to the pathophysiology of SRV failure. The pivotal role of TR is complex as it is due to both the intrinsic abnormalities of the valve (specific to each phenotype) and the consequence of SRV dilation and failure. Medical therapy has not been equivocally proven to be effective for TR. Surgery (valve repair or replacement) has shown conflicting long-term results, mainly dependent on preoperative SRV function. Thus, other management options have been proposed to improve SRV function and valve competency, such as early anatomical correction, pulmonary banding, resynchronization therapy and valvular edge-to-edge percutaneous repair. The aim of this review is to discuss the mechanisms of TR and SRV failure, as well as the available therapeutic options. (c) 2022 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:476 / 486
页数:11
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