Tricuspid regurgitation
Tricuspid regurgitation is called one of types of heart disease at which the insufficiency of the tricuspid (three-leaved) valve leading 
during a systole to the return blood flow from a right ventricle in an auricle is observed.
Tricuspid regurgitation: reasons
Most often development of regurgitation of the tricuspid valve arises against the background of the heart diseases proceeding with expansion of a right ventricle and pulmonary hypertensia. Much less often this disease arises against the background of a septic endocarditis, rheumatism, a carcinoid syndrome, Marfan's syndrome. Insufficiency of the tricuspid valve can be inborn pathology or develop as a result of long reception of some medicines (phentermine, a fenfluramin, ergotamine).
Symptoms
At insignificant defect of shutters of the three-leaved valve (tricuspid regurgitation of 1 degree) the disease usually proves nothing and it is considered a high-quality state which treatment is not carried out. Only a small part of patients has a pulsation of cervical veins caused by increase in pressure in them.
At heavy regurgitation of the tricuspid valve the expressed swelling of jugular veins is observed. Having laid a hand to the right jugular vein it is possible to feel its trembling. Considerable insufficiency of the valve can lead to dysfunction of a right ventricle, emergence of an atrial flutter or ciliary arrhythmia, formation of heart failure.
Tricuspid regurgitation: diagnosis
To make the correct diagnosis at tricuspid regurgitation, and also to define disease degree, it is possible on the basis of data of a Doppler echocardiography. At tricuspid regurgitation of 1 degree the return blood flow from a right ventricle back in the right auricle is swept hardly up. Tricuspid regurgitation 2 degrees is characterized by the return blood flow no more than on 2,0 cm from the three-leaved valve. At the third degree of insufficiency regurgitation exceeds 2,0 cm, and at the fourth – extends on all volume of the right auricle.
As additional methods of a research carry out an ECG and a X-ray analysis of a thorax. On the electrocardiogram quite often reveal signs of a hypertrophy of a right ventricle. On roentgenograms at tricuspid regurgitation of 1 extent of change usually do not come to light. At tricuspid regurgitation 2 degrees are found the increased shadow of an upper vena cava and the right auricle above, and in certain cases and existence of an exudate in a pleural cavity.
Heart catheterization 
as a diagnostic method at regurgitation of the tricuspid valve is carried out extremely seldom.
Treatment of tricuspid regurgitation
Small regurgitation of the tricuspid valve is well transferred by people and does not need performing treatment. Therapy is usually appointed at tricuspid regurgitation 2 – 4 degrees. First of all, it is directed to elimination of the reason which led to development of insufficiency of the three-leaved valve (treatment of rheumatism, septic endocarditis, etc.). In addition, carry out also treatment of the complications caused by tricuspid regurgitation – heart failure, arrhythmia.
In the absence of effect of the carried-out conservative treatment, and also at further progressing of insufficiency of the valve, surgery – prosthetics, plastics of the three-leaved valve or an annuloplasty is shown.
Usually resort to an annuloplasty when the disease develops owing to dilatation (expansion) of a ring of the valve. Prosthetics of the three-leaved valve is shown at its insufficiency caused by Epstein's defect or a carcinoid syndrome. For a prosthesis use the valve of a pig allowing to reduce significantly probability of development in the postoperative period of tromboembolic episodes. As practice shows, the pork valve effectively functions more than 10 years then make its replacement by new.
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