The main causes of death were pulmonary hypertensive crisis and arrhythmia.

Objective This study was designed to evaluate diagnostic value of pulmonary embolism (PE) based on unexplained pulmonary hypertension by transthoracic echocardiography (TTE).

Conclusion tricuspid annular dilatation, right heart impairment and severe pulmonary hypertension are responsible for the development of late tricuspid regurgitation after mitral valve replacement.