Q. Medical therapy for tricuspid stenosis?
Medical therapy is ineffective. With diuretics, symptoms of congestion are replaced by that of low cardiac output state. Occasional cases of balloon tricuspid valvuloplasty are reported. Since tricuspid stenosis is often accompanied by regurgitation and mitral valve disease simultaneous surgical correction with comissurotomy and tricuspid annuloplasty is performed. When tricuspid valve is destroyed badly, tricuspid valve replacement may be needed. In general it is avoided in view of poor long term results. Unrecognized and uncorrected rheumatic tricuspid stenosis can have deleterious effects on the results of mitral and aortic surgery. It is worth repeating that 10 per cent of patients with mitral valve disease and up to 50 per cent of patients with combined mitral and aortic valve disease have associated organic tricuspid valve disease. A diligent echocardiography examination avoids major post operative embarrassment.