Abolished ischemic tricuspid regurgitation by revascularization of left anterior descending artery: The role of collateral circulation

Sungsoo Cho, Jung Hee Lee, Chi Young Shim, Hyuck Jae Chang, Geu Ru Hong, Jong Won Ha, Myeong Ki Hong, Namsik Chung, Seung Yun Cho

Research output: Contribution to journalArticle


A 74-year-old man presented with recent inferior wall myocardial infarction. The right ventricle (RV) was strikingly dilated and akinetic along the free wall compatible with right ventricular infarction. Accordingly, severe functional tricuspid regurgitation (TR) was detected. Coronary angiogram revealed total occlusion on the proximal right coronary artery (RCA). There was collateral blood flow from the left anterior descending (LAD) artery to the right ventricular ischemic region. The LAD artery also had a significant stenosis which might limit the required amount of blood supply to collateral blood vessels. Because of the technical difficulty in the intervention of RCA, the patient underwent percutaneous intervention on the LAD artery. After the revascularization of LAD artery, severe TR was abolished accompanied by the right ventricular functional recovery.<. Learning objective: Isolated ischemic tricuspid regurgitation was rarely manifested because the right ventricle has a more favorable oxygen supply-demand ratio than the left ventricle and receives extensive collateral flow from the left-to-right collateral system. In our case, the right ventricle was receiving blood flow through collateral circulation from septal branches of the left anterior descending coronary artery due to the total occlusion of proximal right coronary artery. This case displays the remarkable role of collateral circulation in restoring right ventricular function and in treating ischemic tricuspid regurgitation.>.

Original languageEnglish
Pages (from-to)9-12
Number of pages4
JournalJournal of Cardiology Cases
Issue number1
Publication statusPublished - 2014 Jul


All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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