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You are here: Contents > 2010 > Volume 19 Number 3 May 2010 > MISCELLANEOUS > Rheumatic Tricuspid Valve Disease: An Evidence-Based Systematic Overview

Rheumatic Tricuspid Valve Disease: An Evidence-Based Systematic Overview

Fateh Ali Tipoo Sultan, Sherif E. Moustafa, Jamil Tajik, Tahlil Warsame, Usha Emani, Mohsen Alharthi, Farouk Mookadam 

Section of Cardiology, Aga Khan University Hospital, Karachi, Pakistan,Aurora Cardiovascular Division, Aurora-St Lukes Hospital, Milwaukee, Wisconsin, Department of Cardiovascular Diseases, Mayo Clinic Scottsdale, AZ, USA

Background and aim of the study: Right-sided valve abnormalities are less common than their left-sided counterparts. Furthermore, whilst organic rheumatic involvement of the tricuspid valve is not uncommon, it receives less attention than left-sided heart valves. An evidence-based systematic overview was carried out to assess the epidemiology, diagnosis and management of organic rheumatic tricuspid valve disease (RTVD) over the past half century.
Methods: A computed search spanning more than four decades was conducted to identify articles on various aspects of RTVD. The bibliographies of all relevant articles were also searched.
Results: A total of 2,497 rheumatic heart disease patients (mean age 25.5 years; female:male ratio 1.3:1) was included. RTVD was detected in 193 patients (7.7%). Echocardiography was used to detect tricuspid valve involvement in all patients. Associated

mitral valve disease was present in 99.3% of the patients with RTVD. A total of 1,092 patients (mean age 45.4 years) was included from six studies on surgical correction of the tricuspid valve. Of these patients, 278 (25.4%) underwent tricuspid valve replacement, while 814 (74.5%) had tricuspid valve repair. The in-hospital mortality was 9.9%, and late mortality 33.2%
Conclusion: RTVD is not uncommon among patients with rheumatic heart disease, but attracts less attention and might, therefore, be overlooked. Echocardiography is the most common diagnostic tool. Although indications for surgical intervention are not well defined, valve repair may have a better outcome than replacement.


The Journal of Heart Valve Disease 2010;19:374-382

Rheumatic Tricuspid Valve Disease: An Evidence-Based Systematic Overview

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