Abstract
A 75-year-old woman presented with dyspnea, and was admitted urgently on a diagnosis of concurrent acute cardiac insufficiency. Because of her low blood pressure and respiratory failure, care was started in the intensive care unit. A transthoracic echocardiogram (TTE) showed severe tricuspid regurgitation (TR). We concluded that her cardiogenic shock was caused by acute right heart failure with severe TR and therefore carried out emergency surgery. We noted expansion of the tricuspid valve ring and shortening of the tendinous cord, and the leaflet was pulled into the right ventricle side. Initially we attempted a tricuspid annuloplasty (TAP), but it proved difficult to control the TR. We therefore performed a tricuspid valve replacement (TVR). The patient was moved from the intensive care unit to a general ward 10 days after the operation, and to another hospital 26 days later.
