TRANSESOPHAGEAL DOPPLER ANALYSIS OF CORONARY SINUS FLOW IN TRICUSPID REGURGITATION

Abstract

In cases of severe tricuspid regurgitation, the high pressure transmitted to the right atrium affects the different venous sources that drain into this chamber. It was hypothesized that severe tricuspid regurgitation may disrupt the normal coronary sinus flow.

The purpose of this study was to analyze the effects of tricuspid regurgitation in Doppler flow pattern of the coronary sinus using transesophageal echocardiography and to determine its value in the assessment of the severity of tricuspid regurgitation.

Our study included 60 patients who had visited to Cardiology Department in Tanta University Hospital, from January 1999 to November 1999.Forty of these patients had some degree of tricuspid regurgitation and the remaining 20 patients were without tricuspid regurgitation and were considered as a control group.

All these patients are subjected to careful history analysis, full clinical examination, resting standard 12 leads electrocardiography, transthoracic echocardiography, and transesophageal echocardiography .

The severity of tricuspid regurgitation by transesophageal echocardiography using the color Doppler jet area ratio was classified as mild in 13 (32.5%) patients, moderate in 8(20%) patients, and severe in 19 (47.5%) patients.

The coronary sinus flow was examined by pulsed Doppler transesophageal echocardiography in a transverse plane which showed its draining into the right atrium. The number of patients with adequate studies of the coronary sinus tended to increase with the severity of the tricuspid regurgitation. In patients without