Echocardiographic findings after tricuspid valvectomy.

Resection of the tricuspid valve without prosthetic replacement has successfully been performed in patients with tricuspid valvular endocarditis. Using M-mode, two-dimensional, and Doppler echocardiograms, we studied four patients who underwent tricuspid valvectomy. All patients had previous history of intravenous drug abuse and staphylococcal endocarditis with tricuspid valvular involvement. In all patients, M-mode and two-dimensional echocardiograms showed that the tricuspid valve was absent. The right ventricle was dilated, and the interventricular septum had paradoxical motion in each patient. In each patient the right atrium was dilated, and with each ventricular systole, it expanded and its short axis increased by 20 to 33 percent. This caused shift of the interatrial septum toward the left atrium, with compression of its cavity. Doppler echocardiographic studies showed retrograde flow during systole in the right atrium, inferior vena cava, and hepatic vein. Echocardiographic findings in patients with tricuspid valvectomy correlate with the pathophysiologic findings of this condition.