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tricuspid regurgitation
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tricuspid regurgitation

I hav went trough a MVR+CBG surgery last year. now it is diagonsed that i hav a severe organic tricuspid regurgitation. The measurements were,
IVSd:10mm  LVSds:34mm  AO:35mm LVIDd:45mm  LVPWs: 12mm LA :48mm  LVPWd :9mm LVEF : 50%  IVSs:10mm FS:27%
MR:0 TR :4+  AR:1 + PR :0 Arotic velocity:1.9m/s  Pulmonary velocity :1 m/s
Mitral Valve: Prosthetic   Arotic valve: Thickened
Tricuspid valve :N  Pulmonary valve:  N
Description :
Prosthetic mitral valve with normal function.  Gradient -10/3 mm Hg
No RWMA, fair LV function, HR fast and irregular
Dilated RA and RV with free tricuspid regurgitation - low pressure.
No tricuspid stensis
Normal RV function.
No pulmonary arterial hypertention noted. RVSP - 20mm Hg
No pericardial effusion/vegetation/clot
Interatrial/interventricular septum intact
Left aortic arxch, no coarctation.


Impression
POST MVR - NORMAL PROSTHETIC VALVE FUNCTION
FAIR LEFT VENTRICULAR SYSTOLIC FUNCTION
SEVERE ORGANIC TRICUSPID REGURGITATION
NO PAH

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Is it necessary to under go another bypass surgery to correct this problem? Please help me?
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367994_tn?1304957193
POST MVR - NORMAL PROSTHETIC VALVE FUNCTION...no problem
FAIR LEFT VENTRICULAR SYSTOLIC FUNCTION...no problem, may improve  
NO PAH....pulmonary hypertension...no problem

SEVERE ORGANIC TRICUSPID REGURGITATION
Tricuspid regurgitation usually results when the right ventricle enlarges and resistance to blood flow from the right ventricle to the lungs is increased. Resistance may be increased by a severe, long-standing lung disorder, such as emphysema or pulmonary hypertension, by disorders involving the left side of the heart, or rarely by narrowing of the pulmonary valve (pulmonic stenosis). To compensate, the right ventricle enlarges, stretching the tricuspid valve and causing regurgitation....You have some right ventricle enlargement, no narrowing of the tricuspid valve that would enlarge the right ventricle.  Regurgitation may have a role in the dilation.

A bypass would not be the correct treatment, but if the regurgitation is severe that may require repair.
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