Materiały źródłowe

• #1 Tricuspid valve regurgitation: current diagnosis and treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/35291509/

  Tricuspid regurgitation (TR) is present in 1.6 million individuals in the United States and 3.0 million people in Europe. […] Echocardiography can assess the TR etiology/severity, measure RA and RV size and function, estimate pulmonary pressure, and characterize LV disease. […] The diagnosis and treatment of TR, including coaptation, annuloplasty devices and prosthetic valves, success rates, morbidity/mortality, and trials are discussed. […] Transcatheter tricuspid valve repair/replacement is an emerging therapy for high-risk patients with TR who would otherwise have a dismal clinical prognosis.

• #2 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  Tricuspid regurgitation (TR) is present in 1.6 million individuals in the United States and 3.0 million people in Europe. […] Echocardiography can assess the TR etiology/severity, measure RA and RV size and function, estimate pulmonary pressure, and characterize LV disease. […] The diagnosis and treatment of TR, including coaptation, annuloplasty devices and prosthetic valves, success rates, morbidity/mortality, and trials are discussed. […] Two- and three-dimensional transthoracic echocardiography (TTE) are useful in differentiating primary from functional TR. In addition, echocardiography is extremely helpful in the evaluation of TR severity, measurement of the RA, tricuspid annulus, RV and inferior vena cava (IVC) sizes, assessing RV systolic contractility, estimating pulmonary artery systolic pressure, and characterizing LV disease.

• #3 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811

  Background: It is estimated that 6% of persons over age 75 have clinically relevant tricuspid regurgitation (TR). This condition carries a high mortality and is of particular interest because of the recent development of new interventional treatments. […] In the outpatient setting, timely diagnosis by transthoracic echocardiography is crucial. […] Although the relevance of TR is undisputed, the disease is still frequently diagnosed too late, and diagnosis is followed by specific treatment in far fewer than 10% of cases. Early diagnosis and evaluation of treatment options would be indicated in order to prevent manifest heart failure, despite the lack, to date, of evidence from randomized controlled trials to back up this recommendation. […] Transthoracic echocardiography is the method of choice for detection of the disease. Simple echocardiography with evaluation of leaflet morphology and function including color-coded Doppler sonography and assessment of the right ventricle suffices for initial diagnosis.

• #4 Problem: Tricuspid Valve Regurgitation | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/problem-tricuspid-valve-regurgitation

  Tricuspid regurgitation is leakage of blood backward through the tricuspid valve each time the right ventricle contracts. […] Tricuspid regurgitation may not have symptoms or the symptoms may be vague, such as weakness and fatigue. The symptoms of tricuspid regurgitation develop due to a backup in volume and pressure from the right side of heart and venous system, resulting in abdominal swelling and engorgement or enlarged liver. […] Treatment may not be required if the symptoms are not bothersome. Any underlying disorder, such as emphysema or pulmonary stenosis, should be treated when possible, and symptoms such as swelling can be managed with medications. […] Surgical valve repair or valve replacement usually corrects the condition. Those with untreated, severe tricuspid regurgitation may face a poor prognosis, either from the valve disease itself or because of complications from the underlying condition causing the valve problem.

• #5

  https://continentalhospitals.com/diseases/tricuspid-valve-regurgitation/

  Tricuspid valve regurgitation is a condition that affects the functioning of the tricuspid valve in the heart. This valve is responsible for ensuring that blood flows properly from the right atrium to the right ventricle. When a person has tricuspid valve regurgitation, it means that there is a leakage of blood back into the right atrium during each heartbeat. […] If you suspect you or someone else is experiencing Tricuspid valve regurgitation symptoms, it is crucial to seek immediate medical attention by calling emergency services or consult with a Cardiologist. […] Diagnosing tricuspid valve regurgitation typically involves a combination of medical history, physical examination, and diagnostic tests. Here’s an overview of the process: […] The doctor will ask about your symptoms, medical history, and any risk factors for heart disease. During the physical exam, the doctor may listen to your heart with a stethoscope to detect any abnormal heart sounds, such as a murmur, which may indicate tricuspid valve regurgitation.

• #6 Tricuspid regurgitation – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/472

  Tricuspid regurgitation usually presents with fatigue, dyspnea, and lower extremity edema. Additional complaints may include abdominal distension and early satiety. […] Mild or moderate tricuspid regurgitation without abnormal valve anatomy, ventricular function, or pulmonary artery pressure is not necessarily abnormal but is estimated to be present in over 50% of asymptomatic young adults. […] The clinically most important form is secondary to left-sided cardiac disease, with tricuspid annular dilation. […] The affected valve may be repaired or replaced; similar to mitral surgery, surgical repair is preferred over replacement. […] Operative risk for tricuspid valve surgery depends on the extent of right ventricular dysfunction and concomitant disease. […] Reoperation for severe tricuspid regurgitation after left-sided valve surgery carries a high risk. Therefore, correction of tricuspid regurgitation should be considered at the time of initial surgery.

• #7 Tricuspid Valve Regurgitation | Diagnosis | UK Healthcare

  https://ukhealthcare.uky.edu/gill-heart-vascular-institute/conditions/structural-heart-disease/tricuspid-valve-regurgitation/diagnosis

  Tricuspid valve regurgitation often has no symptoms, and its commonly diagnosed while imaging studies are being done for other conditions. However, if your healthcare provider believes you have tricuspid valve regurgitation, they may perform a physical exam and cardiovascular imaging studies. […] Your doctor may conduct a physical exam to begin diagnosing a suspected case of tricuspid valve regurgitation. During this exam, the doctor may press their hand on your chest to feel for palpitations. They may also notice pulsation of your liver, as well as swelling of your liver or your spleen. In addition, your doctor will listen to your heart using a stethoscope. Unusual sounds, such as a murmur, are clues that your ventricle may not be functioning correctly. […] After your physical exam, your doctor may further investigate by ordering an echocardiogram (ECG or echo). This type of test records activity of the heart using high-frequency sound waves, or ultrasound. A technologist called a sonographer conducts this test by applying gel to your chest that makes it easier for sound waves to reach your heart. The sonographer will then move a transducer across your chest to send sound waves to your heart. The echo created by those waves is translated into images of your heart as it beats. […] Your doctor may gather more information by ordering additional imaging tests to see if the right side of your heart is enlarged or if other changes are present.

• #8 Tricuspid regurgitation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000169.htm

  Tricuspid regurgitation is a disorder in which this valve does not close tight enough. This problem causes blood to flow backward into the right atrium when the right ventricle contracts. […] The health care provider may find abnormalities when gently pressing with the hand (palpating) on your chest. The provider may also feel a pulse over your liver. The physical exam may show liver and spleen swelling. […] Listening to the heart with a stethoscope may reveal a murmur or other abnormal sounds. There may be signs of fluid buildup in the abdomen. […] An electrocardiogram (ECG) or echocardiogram may show enlargement of the right side of the heart. Doppler echocardiography or right-sided cardiac catheterization may be used to measure blood pressure inside the heart and lungs. […] Other tests, such as CT scan or MRI of the chest (heart), may reveal enlargement of the right side of the heart and other changes.

• #9 Tricuspid regurgitation – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/472

  The disease has largely been undertreated and its impact is under appreciated. […] Key diagnostic factors include fatigue and effort intolerance, dyspnea, palpitations, jugular venous abnormality, irregular heart rhythm, parasternal systolic murmur, increased systolic murmur on inspiration (Carvallo sign), and peripheral edema. […] 1st tests to order include transthoracic or transesophageal echocardiogram, ECG, LFTs, serum BUN and creatinine, CBC, and CXR. […] Tests to consider include operative transesophageal echocardiogram, postoperative transthoracic echocardiogram, cardiac catheterization, and cardiac MRI (preferred technique for evaluation of right ventricular size and function).

• #10 Tricuspid regurgitation – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/472

  The disease has largely been undertreated and its impact is under appreciated. […] Key diagnostic factors include presence of risk factors, fatigue and effort intolerance, dyspnoea, palpitations, jugular venous abnormality, irregular heart rhythm, parasternal systolic murmur, increased systolic murmur on inspiration (Carvallo’s sign), and peripheral oedema. […] 1st investigations to order include transthoracic or transoesophageal echocardiogram, ECG, LFTs, serum urea and creatinine, FBC, and CXR. […] Investigations to consider include operative transoesophageal echocardiogram, postoperative transthoracic echocardiogram, cardiac catheterisation, and cardiac MRI (preferred technique for evaluation of right ventricular size and function).

• #11 Tricuspid valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-disease/diagnosis-treatment/drc-20573710

  To diagnose tricuspid valve disease, a healthcare professional examines you and listens to your heart and lungs. Tests are done to check heart health. Tricuspid valve disease may be found when tests are done for another reason. […] Some types of tricuspid valve disease may be hard to diagnose. You may be sent to a doctor trained in heart diseases, called a cardiologist. […] Tests to diagnose tricuspid valve disease may include: […] Echocardiogram. Sound waves create pictures of the beating heart. This test shows how blood moves through the heart and heart valves. It can show if the tricuspid valve is thickened or changed. […] After testing confirms a diagnosis of tricuspid valve disease, your healthcare team may tell you the stage of disease. Staging helps determine the most appropriate treatment.

• #12 Tricuspid valve regurgitation: current diagnosis and treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/35291509/

  Tricuspid regurgitation (TR) is present in 1.6 million individuals in the United States and 3.0 million people in Europe. […] Echocardiography can assess the TR etiology/severity, measure RA and RV size and function, estimate pulmonary pressure, and characterize LV disease. […] The diagnosis and treatment of TR, including coaptation, annuloplasty devices and prosthetic valves, success rates, morbidity/mortality, and trials are discussed. […] Transcatheter tricuspid valve repair/replacement is an emerging therapy for high-risk patients with TR who would otherwise have a dismal clinical prognosis.

• #13 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  Tricuspid regurgitation (TR) is present in 1.6 million individuals in the United States and 3.0 million people in Europe. […] Echocardiography can assess the TR etiology/severity, measure RA and RV size and function, estimate pulmonary pressure, and characterize LV disease. […] The diagnosis and treatment of TR, including coaptation, annuloplasty devices and prosthetic valves, success rates, morbidity/mortality, and trials are discussed. […] Two- and three-dimensional transthoracic echocardiography (TTE) are useful in differentiating primary from functional TR. In addition, echocardiography is extremely helpful in the evaluation of TR severity, measurement of the RA, tricuspid annulus, RV and inferior vena cava (IVC) sizes, assessing RV systolic contractility, estimating pulmonary artery systolic pressure, and characterizing LV disease.

• #14 Tricuspid valve regurgitation: no longer the “forgotten valve”

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Tricuspid-valve-regurgitation-no-longer-the-forgotten-valve

  Tricuspid regurgitation (TR) is a highly prevalent valvular heart disease. […] In the diagnosis for TR, an accurate evaluation of the complex tricuspid anatomy and remodelling of the right ventricle is pivotal. […] A comprehensive understanding of the tricuspid valve morphology, its anatomical variability and the interaction of all its functional components with the valve apparatus (tricuspid annulus, leaflets, chordae tendineae and papillary muscles, RV and atrium) is essential to establish and fine-tune the diagnosis of TR. […] In daily clinical practice, two-dimensional (2D) transthoracic echocardiography remains the cornerstone in establishing the diagnosis of TR and grading its severity by providing qualitative, semi-quantitative and quantitative parameters. […] By combining the aforementioned parameters, current guidelines advocate a multiparametric approach to improve the diagnostic accuracy of severe TR.

• #15 Tricuspid Regurgitation – Diagnosis

  https://www.my-connext.com/valvular-diseases/tricuspid/diagnosis?spec=20

  Echocardiography is the key technique used to confirm the diagnosis of VHD, as well as to assess its aetiology, mechanisms, function, severity, and prognosis. Echocardiography is typically used in assessing both the mechanism and severity of TR. […] TransThoracic Echocardiography (TTE) can distinguish between primary and secondary TR, identify comorbid LSHD, and estimate pulmonary artery systolic pressure. […] In the presence of TR, tricuspid valve analysis is mandatory; two-dimensional (2D)-TTE imaging is the technique of choice. Three-dimensional (3D)-TTE can be used as an additive approach. […] TransoEsophageal Echocardiography (TEE) is advised in case of suboptimal TTE images. Distinction between primary and secondary TR is warranted. […] CMR assessment of TR is feasible, it is less established than for other valves. Patients with inadequate echocardiography may receive CMR imaging to assess the severity of valvular lesions, ventricular volume, or systolic function, thus CMR can aid the evaluation of TR severity.

• #16 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  Tricuspid regurgitation (TR) is present in 1.6 million individuals in the United States and 3.0 million people in Europe. […] Echocardiography can assess the TR etiology/severity, measure RA and RV size and function, estimate pulmonary pressure, and characterize LV disease. […] The diagnosis and treatment of TR, including coaptation, annuloplasty devices and prosthetic valves, success rates, morbidity/mortality, and trials are discussed. […] Two- and three-dimensional transthoracic echocardiography (TTE) are useful in differentiating primary from functional TR. In addition, echocardiography is extremely helpful in the evaluation of TR severity, measurement of the RA, tricuspid annulus, RV and inferior vena cava (IVC) sizes, assessing RV systolic contractility, estimating pulmonary artery systolic pressure, and characterizing LV disease.

• #17 Tricuspid valve regurgitation | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20120486/

  There are different types of echocardiograms. A standard echocardiogram is called a transthoracic echocardiogram (TTE). It creates pictures of the heart from outside the body. Sometimes, a more-detailed echocardiogram is needed to better see the tricuspid valve. This test is called a transesophageal echocardiogram (TEE). It creates pictures of the heart from inside the body. The type of echocardiogram you have depends on the reason for the test and your overall health. […] Electrocardiogram (ECG or EKG). This quick test records the electrical signals in the heart. It shows how the heart is beating. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Cardiac MRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. Cardiac MRI may help show the severity of tricuspid valve regurgitation. The test also gives details about the lower right heart chamber.

• #18 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  There are different types of echocardiograms. A standard echocardiogram is called a transthoracic echocardiogram (TTE). It creates pictures of the heart from outside the body. Sometimes, a more-detailed echocardiogram is needed to better see the tricuspid valve. This test is called a transesophageal echocardiogram (TEE). It creates pictures of the heart from inside the body. The type of echocardiogram you have depends on the reason for the test and your overall health. […] Electrocardiogram (ECG or EKG). This quick test records the electrical signals in the heart. It shows how the heart is beating. Sensors, called electrodes, stick to the chest and sometimes the legs. Wires connect the sensors to a computer, which displays or prints results. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs.

• #19 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  Tricuspid regurgitation (TR) is present in 1.6 million individuals in the United States and 3.0 million people in Europe. […] Echocardiography can assess the TR etiology/severity, measure RA and RV size and function, estimate pulmonary pressure, and characterize LV disease. […] The diagnosis and treatment of TR, including coaptation, annuloplasty devices and prosthetic valves, success rates, morbidity/mortality, and trials are discussed. […] Two- and three-dimensional transthoracic echocardiography (TTE) are useful in differentiating primary from functional TR. In addition, echocardiography is extremely helpful in the evaluation of TR severity, measurement of the RA, tricuspid annulus, RV and inferior vena cava (IVC) sizes, assessing RV systolic contractility, estimating pulmonary artery systolic pressure, and characterizing LV disease.

• #20 Tricuspid Regurgitation – Diagnosis

  https://www.my-connext.com/valvular-diseases/tricuspid/diagnosis?spec=20

  Echocardiography is the key technique used to confirm the diagnosis of VHD, as well as to assess its aetiology, mechanisms, function, severity, and prognosis. Echocardiography is typically used in assessing both the mechanism and severity of TR. […] TransThoracic Echocardiography (TTE) can distinguish between primary and secondary TR, identify comorbid LSHD, and estimate pulmonary artery systolic pressure. […] In the presence of TR, tricuspid valve analysis is mandatory; two-dimensional (2D)-TTE imaging is the technique of choice. Three-dimensional (3D)-TTE can be used as an additive approach. […] TransoEsophageal Echocardiography (TEE) is advised in case of suboptimal TTE images. Distinction between primary and secondary TR is warranted. […] CMR assessment of TR is feasible, it is less established than for other valves. Patients with inadequate echocardiography may receive CMR imaging to assess the severity of valvular lesions, ventricular volume, or systolic function, thus CMR can aid the evaluation of TR severity.

• #21 Tricuspid Regurgitation – Diagnosis

  https://www.my-connext.com/valvular-diseases/tricuspid/diagnosis?spec=20

  Echocardiography is the key technique used to confirm the diagnosis of VHD, as well as to assess its aetiology, mechanisms, function, severity, and prognosis. Echocardiography is typically used in assessing both the mechanism and severity of TR. […] TransThoracic Echocardiography (TTE) can distinguish between primary and secondary TR, identify comorbid LSHD, and estimate pulmonary artery systolic pressure. […] In the presence of TR, tricuspid valve analysis is mandatory; two-dimensional (2D)-TTE imaging is the technique of choice. Three-dimensional (3D)-TTE can be used as an additive approach. […] TransoEsophageal Echocardiography (TEE) is advised in case of suboptimal TTE images. Distinction between primary and secondary TR is warranted. […] CMR assessment of TR is feasible, it is less established than for other valves. Patients with inadequate echocardiography may receive CMR imaging to assess the severity of valvular lesions, ventricular volume, or systolic function, thus CMR can aid the evaluation of TR severity.

• #22 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points […] The following are key points to remember from a state-of-the-art paper on tricuspid regurgitation (TR): from imaging to clinical trials to resolving the unmet need for treatment. […] TR is prevalent and associated with high mortality but underdiagnosed and profoundly undertreated by surgery. Challenges in intervention for TR include poor outcomes and TR recurrence after surgical intervention, and persistent or recurrent TR and residual right ventricular (RV) consequences after transcatheter repair. This review addresses TR diagnosis, quantification, multimodality imaging, and management. […] Diagnostic imaging for tricuspid valve (TV) structure and TR severity: […] Echocardiographic assessment should include TV morphologic assessment and TR causes and mechanism; three-dimensional (3D) echocardiography can be especially useful. TR assessment should be quantitative, with severe TR defined by effective regurgitant orifice area 0.40 cm2.

• #23 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811

  Diagnosis of clinically significant TR should prompt more detailed exploration at a heart valve center. The tricuspid valve pathology has to be evaluated, the underlying causes of TR have to be identified, and the cardiac and extracardiac implications have to be delineated. […] The severity of TR is assessed by means of multiparametric measurements (qualitative, quantitative, and semiquantitative). […] If significant and symptomatic TR persists despite optimal treatment of underlying conditions and medical therapy, one should weigh up whether specific tricuspid valve treatment is indicated. […] The currently prevailing guidelines recommend tricuspid valve surgery, with simultaneous operative treatment of the left heart in the presence of severe TR or dilatation of the tricuspid annulus in patients with low surgical risk.

• #24 Tricuspid Regurgitation – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/tricuspid-regurgitation

  Tricuspid regurgitation (TR) is insufficiency of the tricuspid valve causing blood flow from the right ventricle to the right atrium during systole. […] Diagnosis is by physical examination and echocardiography. […] More moderate or severe TR may be suggested by history and physical examination. Confirmation is by echocardiography. […] Severe TR is characterized echocardiographically by 1 of the following: 2-Dimensional failure of coaptation or flail, Dense, triangular, early peaking, continuous wave Doppler of TR jet, Large flow convergence zone proximal to the valve, Large regurgitant jet on color Doppler ( 50% of right atrial area), Systolic flow reversal in the hepatic veins (specific for severe TR), Vena contracta width 7 mm. […] When TR is moderate or severe, the peak regurgitant velocity will underestimate pulmonary pressure.

• #25 Tricuspid regurgitation (TR/TI) – Echocardiography, diagnosis, causes, management

  https://ecgwaves.com/topic/tricuspid-regurgitation-tr-ti/

  Approximately 85%-90% of healthy individuals in the general population exhibit a small tricuspid regurgitation, which is considered a normal finding. Pathological tricuspid regurgitation is more pronounced. Echocardiography is the preferred method for diagnosing tricuspid regurgitation. […] Two-dimensional echocardiography is used to evaluate valve anatomy and the subvalvular apparatus. Thickness, mobility and coaptation of the leaflets are assessed visually in multiple views. […] Cardiac MRI is, however, the gold standard for assessing right ventricular anatomy and function. […] The regurgitation is considered severe if the tricuspid annulus diameter is 4 cm. Severe tricuspid regurgitation results in right ventricular and atrial dilation. […] The regurgitant jet area (in the right atrium) should be measured and compared to the area of the right atrium. If the jet area is 40% of the atrial area, then the regurgitation is severe. […] Vena contracta should also be measured; 0.7 cm is indicative of severe regurgitation.

• #26 Heart valve disease module 4: diagnosis – The British Journal of Cardiology

  https://bjcardio.co.uk/2016/03/heart-valve-disease-module-4-diagnosis-2/7/

  The minimum echocardiographic dataset for the tricuspid valve consists of: […] Tricuspid regurgitation is graded by the width of the vena contracta of the systolic colour signal in multiple views. A width 7 mm is indicative of severe regurgitation although there are no well validated cut-offs for differentiating mild from moderate tricuspid regurgitation. […] In severe regurgitation, the signal is intense and triangular in shape. The jet is a useful means for assessing the tricuspid regurgitation (TR) severity. […] Where possible, a pulsed wave (PW) Doppler trace should be obtained within the hepatic vein, looking for systolic flow reversal (80% sensitivity for severe TR). […] In severe compensated TR, the RV may be normal in size but demonstrate dynamic systolic function. […] Tricuspid regurgitation may be seen as a black signal void with cine imaging. Regurgitant volumes and fraction can be calculated by measuring the forward stroke volume in the main pulmonary artery and subtracting this from the RV stroke volume on SSFP imaging, although this is not used clinically.

• #27 Tricuspid Regurgitation – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/tricuspid-regurgitation

  Tricuspid regurgitation (TR) is insufficiency of the tricuspid valve causing blood flow from the right ventricle to the right atrium during systole. […] Diagnosis is by physical examination and echocardiography. […] More moderate or severe TR may be suggested by history and physical examination. Confirmation is by echocardiography. […] Severe TR is characterized echocardiographically by 1 of the following: 2-Dimensional failure of coaptation or flail, Dense, triangular, early peaking, continuous wave Doppler of TR jet, Large flow convergence zone proximal to the valve, Large regurgitant jet on color Doppler ( 50% of right atrial area), Systolic flow reversal in the hepatic veins (specific for severe TR), Vena contracta width 7 mm. […] When TR is moderate or severe, the peak regurgitant velocity will underestimate pulmonary pressure.

• #28 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  The vena contracta width measurement is not valid for multiple TR jets into the right atrium. […] In patients with poor 2D TTE imagines of the TV and when 3D echocardiography is not available for assessing the TV, RV volumes and function, cardiac magnetic resonance (CMR) imaging is useful in the assessment of the TV and RV morphology and function. […] Right and left heart catheterization should be performed when there is inconsistency between the clinical findings and the results of non-invasive tests to rule out primary pulmonary or LV etiologies as the cause of the patients symptoms. […] A multidisciplinary heart team that includes a cardiothoracic surgeon, an interventional cardiologist, an echocardiographer, an anesthesiologist, and the patients primary physician is recommended to property treat high-risk patients with severe TR.

• #29 Tricuspid Regurgitation – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/tricuspid-regurgitation

  Cardiac MRI is the preferred method for evaluating RV size and function. […] An ECG and chest x-ray are often done. […] Cardiac catheterization is indicated for accurate measurement of pulmonary pressure when TR is severe and to evaluate coronary anatomy when surgery is planned. […] Very mild tricuspid regurgitation is a normal finding and requires no action. […] Medical therapy with loop diuretics can relieve congestion. […] Timing of intervention for tricuspid regurgitation depends on the patient’s symptoms and RV function. […] Surgical options include Annuloplasty, Valve repair, Valve replacement. […] Tricuspid valve replacement is indicated when TR is due to carcinoid syndrome or Ebstein anomaly. […] Progress is being made toward a percutaneous valve repair procedure. […] Severe tricuspid regurgitation ultimately has a poor prognosis, even if it is initially well-tolerated for years. […] TR is usually well tolerated, but severe cases may require annuloplasty, valve repair, or valve replacement.

• #30 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  The vena contracta width measurement is not valid for multiple TR jets into the right atrium. […] In patients with poor 2D TTE imagines of the TV and when 3D echocardiography is not available for assessing the TV, RV volumes and function, cardiac magnetic resonance (CMR) imaging is useful in the assessment of the TV and RV morphology and function. […] Right and left heart catheterization should be performed when there is inconsistency between the clinical findings and the results of non-invasive tests to rule out primary pulmonary or LV etiologies as the cause of the patients symptoms. […] A multidisciplinary heart team that includes a cardiothoracic surgeon, an interventional cardiologist, an echocardiographer, an anesthesiologist, and the patients primary physician is recommended to property treat high-risk patients with severe TR.

• #31 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Cardiac magnetic resonance (CMR) imaging can assess TR severity and RV function. […] Computed tomography (CT) can be complementary to transesophageal echocardiography (TEE) for the assessment of TV leaflet anatomy and TR mechanism, and for anatomical measurements associated with intervention. […] Cardiac catheterization can be useful in the assessment of PH. […] Current and developing interventions: […] Tricuspid annuloplasty is the standard of care for surgical intervention. Valve replacement might be preferable in patients with severe RV dilation and distorted subvalvular apparatus. […] T-TEER is the dominant transcatheter intervention for TR. Evolving options for transcatheter intervention include incorporation of a spacer in the T-TEER device, leaflet extensions, subvalvular manipulations, and new devices.

• #32 Tricuspid valve regurgitation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/tricuspid-valve-regurgitation-1?lang=us

  Tricuspid valve regurgitation (TR), also known as tricuspid valve insufficiency or tricuspid valve incompetence (TI), is a valvulopathy that describes leaking of the tricuspid valve (TV) during systole that causes blood to flow in the reverse direction from the right ventricle (RV) into the right atrium (RA). […] Echocardiography is useful for evaluating the cause of tricuspid regurgitation, for assessing the regurgitant volume, and for assessing the right-sided cardiac chambers. […] The echocardiographic detection of tricuspid regurgitation is common and present in approximately 70% of people. […] The degree of tricuspid regurgitation may be calculated in terms of regurgitant volume and fraction in similar ways to mitral regurgitation – i.e. subtraction of the forward stroke volume (as measured in the pulmonary artery with phase contrast) from the total right ventricular stroke volume (obtained from SSFP images).

• #33 Tricuspid Regurgitation

  https://mydoctor.kaiserpermanente.org/mas/article/tricuspid-regurgitation-744501

  Transesophageal echocardiogram (TEE). We get a better picture of the heart by using this test. After giving you light sedation, we will place a wand in a small flexible tube down your throat and into your food pipe (esophagus). […] Stress echocardiogram. We will be able to see if the heart valve problem is affecting the ability of your heart to work hard. This test is performed before and after you exercise, usually on a treadmill. […] Cardiac MRI. By using a powerful magnet to make images of your heart, we can determine the degree of regurgitation and the size and function of the right ventricle.

• #34 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Cardiac magnetic resonance (CMR) imaging can assess TR severity and RV function. […] Computed tomography (CT) can be complementary to transesophageal echocardiography (TEE) for the assessment of TV leaflet anatomy and TR mechanism, and for anatomical measurements associated with intervention. […] Cardiac catheterization can be useful in the assessment of PH. […] Current and developing interventions: […] Tricuspid annuloplasty is the standard of care for surgical intervention. Valve replacement might be preferable in patients with severe RV dilation and distorted subvalvular apparatus. […] T-TEER is the dominant transcatheter intervention for TR. Evolving options for transcatheter intervention include incorporation of a spacer in the T-TEER device, leaflet extensions, subvalvular manipulations, and new devices.

• #35 What Is Tricuspid Valve Regurgitation?

  https://www.icliniq.com/articles/heart-circulatory-health/tricuspid-valve-regurgitation

  Tricuspid regurgitation is a relatively common condition that results from structural abnormalities of any part of the tricuspid valve functioning and modifying parts of the tricuspid valve. […] TR happens when the heart’s tricuspid valve does not seal completely, resulting in backward blood flow. […] How Is the Tricuspid Regurgitation Diagnosed? […] Electrocardiogram (ECG): On ECG, right ventricle hypertrophy and right atrial enlargement, right axis deviation can be seen, which clues to TR. […] Echocardiography: It is extremely useful in the evaluation of TR severity. It is also helpful in differentiating primary and functional TR. During echocardiography, TR is detected using color Doppler imaging. […] Chest Radiography: It may detect some findings related to TR as followings: Marked enlargement of the heart in severe cases of TR.

• #36 Tricuspid Regurgitation – Hope For Hearts

  https://hopeforhearts.com.au/structural-heart-disease/tricuspid-regurgitation/

  Tricuspid regurgitation refers to an abnormal leaking of blood across the tricuspid valve. This condition occurs due to insufficient closure of the tricuspid valve, this causes blood to be pushed back into the right atrium when the ventricle contracts and can lead to increased pressure in the atrium. […] Similar to many suspected valvular conditions, a formal diagnosis of Tricuspid Regurgitation is made usually after an Echocardiogram (Echo) has been performed. An echo helps in identifying the severity of tricuspid regurgitation as well as other structural heart abnormalities. […] Other helpful diagnostic tests may be: Chest X-ray, Cardiac MRI, Blood tests, Electrocardiograph (ECG) which can show right bundle branch block, T wave inversion or presence of atrial fibrillation.

• #37 Tricuspid Regurgitation

  https://mydoctor.kaiserpermanente.org/mas/article/tricuspid-regurgitation-744501

  A chest X-ray or echocardiogram can usually diagnose your heart valve problem, or you might need a heart catheterization. […] A test as simple as a chest X-ray or echocardiogram may be used to diagnose your heart valve problem. Other tests can also help us diagnose your condition: […] Electrocardiogram (ECG/EKG). We will check your heart rate, heart rhythm, and the size of the heart chambers. […] Chest X-ray. We are looking to see whether you have an enlarged heart or if your valve is calcified or stiffened. […] Echocardiogram. We use sound waves to examine how your heart works while it beats. The test shows the size and shape of your heart valves and heart muscle, how well your heart pumps blood, and any stiffness or leakage of your valves. […] Cardiac catheterization. We check the function of your heart valves and measure any leakage through the valves. For this test, we thread a small catheter into one of your blood vessels and into your heart.

• #38 Tricuspid valve regurgitation | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20120486/

  There are different types of echocardiograms. A standard echocardiogram is called a transthoracic echocardiogram (TTE). It creates pictures of the heart from outside the body. Sometimes, a more-detailed echocardiogram is needed to better see the tricuspid valve. This test is called a transesophageal echocardiogram (TEE). It creates pictures of the heart from inside the body. The type of echocardiogram you have depends on the reason for the test and your overall health. […] Electrocardiogram (ECG or EKG). This quick test records the electrical signals in the heart. It shows how the heart is beating. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Cardiac MRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. Cardiac MRI may help show the severity of tricuspid valve regurgitation. The test also gives details about the lower right heart chamber.

• #39 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  The vena contracta width measurement is not valid for multiple TR jets into the right atrium. […] In patients with poor 2D TTE imagines of the TV and when 3D echocardiography is not available for assessing the TV, RV volumes and function, cardiac magnetic resonance (CMR) imaging is useful in the assessment of the TV and RV morphology and function. […] Right and left heart catheterization should be performed when there is inconsistency between the clinical findings and the results of non-invasive tests to rule out primary pulmonary or LV etiologies as the cause of the patients symptoms. […] A multidisciplinary heart team that includes a cardiothoracic surgeon, an interventional cardiologist, an echocardiographer, an anesthesiologist, and the patients primary physician is recommended to property treat high-risk patients with severe TR.

• #40 Tricuspid valve regurgitation | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20120486/

  Cardiac catheterization. This test isn’t often used to diagnose tricuspid valve disease. But it can be helpful if other tests haven’t diagnosed the cause of the condition. A doctor guides a thin, flexible tube called a catheter through a blood vessel in the arm or groin. It’s moved to an artery in the heart. Dye flows through the tube. This makes the heart arteries show up more clearly on X-rays taken during the test. Pressures in the heart also can be measured during this test.

• #41 Tricuspid Regurgitation – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/tricuspid-regurgitation

  Cardiac MRI is the preferred method for evaluating RV size and function. […] An ECG and chest x-ray are often done. […] Cardiac catheterization is indicated for accurate measurement of pulmonary pressure when TR is severe and to evaluate coronary anatomy when surgery is planned. […] Very mild tricuspid regurgitation is a normal finding and requires no action. […] Medical therapy with loop diuretics can relieve congestion. […] Timing of intervention for tricuspid regurgitation depends on the patient’s symptoms and RV function. […] Surgical options include Annuloplasty, Valve repair, Valve replacement. […] Tricuspid valve replacement is indicated when TR is due to carcinoid syndrome or Ebstein anomaly. […] Progress is being made toward a percutaneous valve repair procedure. […] Severe tricuspid regurgitation ultimately has a poor prognosis, even if it is initially well-tolerated for years. […] TR is usually well tolerated, but severe cases may require annuloplasty, valve repair, or valve replacement.

• #42

  https://continentalhospitals.com/diseases/tricuspid-valve-regurgitation/

  This invasive procedure involves threading a thin tube (catheter) through a blood vessel and into the heart to measure pressures and assess the severity of tricuspid regurgitation. It’s usually reserved for cases where other tests haven’t provided enough information or when additional information is needed for treatment planning.

• #43 Stages of Tricuspid Regurgitation by Severity and Treatment

  https://www.healthline.com/health/stages-of-tricuspid-regurgitation

  Tricuspid regurgitation is a condition divided into four stages based on several factors. […] The American College of Cardiology (ACC) and American Heart Association (AHA) divide tricuspid regurgitation into stages A-D based on: symptoms, valve anatomy, severity of valve dysfunction. […] Transthoracic echocardiography is the primary test that doctors use to measure the stages of tricuspid regurgitation. Other tests a doctor may use to diagnose each stage include: MRI scan, electrocardiogram, chest X-rays, cardiac catheterization. […] Stage A tricuspid regurgitation typically doesn’t require treatment. […] The ACC and AHA guidelines recommend tricuspid valve surgery for people with stage B disease who are undergoing left-sided valve surgery and have either of the following: enlargement of the annulus greater than 4 centimeters, prior symptoms of right-sided heart failure.

• #44 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] Heart valve disease is staged into four basic groups: Stage A: At risk. Risk factors for heart valve disease are present. Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms. Stage C: Asymptomatic severe. There are no heart valve symptoms, but the valve disease is severe. Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.

• #45 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] Heart valve disease is staged into four basic groups: Stage A: At risk. Risk factors for heart valve disease are present. Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms. Stage C: Asymptomatic severe. There are no heart valve symptoms, but the valve disease is severe. Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.

• #46 Tricuspid Valve Regurgitation | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/triscuspid-valve-regurgitation

  The four stages of tricuspid valve regurgitation include: At-risk: You have risk factors for heart valve disease that require monitoring; Progressive: Mild valve disease doesnt cause symptoms, but may require treatment; Asymptomatic severe: Severe valve disease doesnt cause symptoms, but may require treatment; Symptomatic severe: Severe valve disease causes serious symptoms and may require treatment. […] Mild or trace tricuspid valve regurgitation rarely requires treatment. However, your provider may recommend more frequent heart tests to monitor the condition. Moderate to severe tricuspid valve disease requires treatment to prevent serious heart complications.

• #47 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] Heart valve disease is staged into four basic groups: Stage A: At risk. Risk factors for heart valve disease are present. Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms. Stage C: Asymptomatic severe. There are no heart valve symptoms, but the valve disease is severe. Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.

• #48 Tricuspid Valve Regurgitation Diagnosis | Temple Health

  https://www.templehealth.org/services/conditions/tricuspid-valve-regurgitation/diagnosis

  Holter monitor is used to give a detailed analysis of the hearts electrical activity over a period of 24 hours (1 day). For this non-invasive test, which is done at home, 4 or 5 adhesive electrodes are placed on the chest and connected to an electrical recording device that is usually worn on the belt or on a neck/shoulder strap. This device records every heartbeat for the duration of the time that its worn. […] Other possible tests may include: exercise stress test, special cardiac Doppler studies, and radionuclide scans.

• #49 Tricuspid Regurgitation

  https://mydoctor.kaiserpermanente.org/mas/article/tricuspid-regurgitation-744501

  Transesophageal echocardiogram (TEE). We get a better picture of the heart by using this test. After giving you light sedation, we will place a wand in a small flexible tube down your throat and into your food pipe (esophagus). […] Stress echocardiogram. We will be able to see if the heart valve problem is affecting the ability of your heart to work hard. This test is performed before and after you exercise, usually on a treadmill. […] Cardiac MRI. By using a powerful magnet to make images of your heart, we can determine the degree of regurgitation and the size and function of the right ventricle.

• #50 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  The vena contracta width measurement is not valid for multiple TR jets into the right atrium. […] In patients with poor 2D TTE imagines of the TV and when 3D echocardiography is not available for assessing the TV, RV volumes and function, cardiac magnetic resonance (CMR) imaging is useful in the assessment of the TV and RV morphology and function. […] Right and left heart catheterization should be performed when there is inconsistency between the clinical findings and the results of non-invasive tests to rule out primary pulmonary or LV etiologies as the cause of the patients symptoms. […] A multidisciplinary heart team that includes a cardiothoracic surgeon, an interventional cardiologist, an echocardiographer, an anesthesiologist, and the patients primary physician is recommended to property treat high-risk patients with severe TR.

• #51 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  In both the American and European guidelines for the management of valvular heart disease, the treatment algorithm for TR must begin with the assessment of the aetiology of regurgitation since the treatment of primary valvular disorders differs from the management of secondary TR. Once determined, the mechanism of regurgitation is defined. […] The diagnostic test of choice is echocardiography; however, there are roles for both cardiac magnetic resonance imaging and computed tomography. […] Echocardiography is instrumental in determining the aetiology of TR, evaluating the mechanism and haemodynamic consequences of TR on cardiac remodelling. Grading of the severity of the TR has been well described in the American Society of Echocardiography (ASE) guidelines as well as in the European Association of Echocardiography guidelines.

• #52 Tricuspid valve regurgitation: no longer the “forgotten valve”

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Tricuspid-valve-regurgitation-no-longer-the-forgotten-valve

  Tricuspid regurgitation (TR) is a highly prevalent valvular heart disease. […] In the diagnosis for TR, an accurate evaluation of the complex tricuspid anatomy and remodelling of the right ventricle is pivotal. […] A comprehensive understanding of the tricuspid valve morphology, its anatomical variability and the interaction of all its functional components with the valve apparatus (tricuspid annulus, leaflets, chordae tendineae and papillary muscles, RV and atrium) is essential to establish and fine-tune the diagnosis of TR. […] In daily clinical practice, two-dimensional (2D) transthoracic echocardiography remains the cornerstone in establishing the diagnosis of TR and grading its severity by providing qualitative, semi-quantitative and quantitative parameters. […] By combining the aforementioned parameters, current guidelines advocate a multiparametric approach to improve the diagnostic accuracy of severe TR.

• #53 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  The current grading scheme for TR fails to capture the severity of regurgitation in patients currently presenting for treatment in early feasibility trials of transcatheter devices. […] The decision on whom, how and when to treat should be based on a comprehensive understanding of the mechanism of FTR, its severity, the characteristics of the right ventricle, the pulmonary circulation, the loading conditions, and the presence/absence of rhythm disturbances. […] Surgery is the most established therapy for FTR. Available guidelines are mainly focused on FTR management at the time of surgery for left-sided valvular lesions. […] As mentioned above, only a small fraction of patients are currently being offered surgical intervention, mostly due to high operative risk related to multiple comorbidities and late presentation or referral for intervention. This has sparked the development of numerous percutaneous transcatheter devices.

• #54 Tricuspid valve regurgitation: current diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8918740/

  The vena contracta width measurement is not valid for multiple TR jets into the right atrium. […] In patients with poor 2D TTE imagines of the TV and when 3D echocardiography is not available for assessing the TV, RV volumes and function, cardiac magnetic resonance (CMR) imaging is useful in the assessment of the TV and RV morphology and function. […] Right and left heart catheterization should be performed when there is inconsistency between the clinical findings and the results of non-invasive tests to rule out primary pulmonary or LV etiologies as the cause of the patients symptoms. […] A multidisciplinary heart team that includes a cardiothoracic surgeon, an interventional cardiologist, an echocardiographer, an anesthesiologist, and the patients primary physician is recommended to property treat high-risk patients with severe TR.

• #55 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811

  Diagnosis of clinically significant TR should prompt more detailed exploration at a heart valve center. The tricuspid valve pathology has to be evaluated, the underlying causes of TR have to be identified, and the cardiac and extracardiac implications have to be delineated. […] The severity of TR is assessed by means of multiparametric measurements (qualitative, quantitative, and semiquantitative). […] If significant and symptomatic TR persists despite optimal treatment of underlying conditions and medical therapy, one should weigh up whether specific tricuspid valve treatment is indicated. […] The currently prevailing guidelines recommend tricuspid valve surgery, with simultaneous operative treatment of the left heart in the presence of severe TR or dilatation of the tricuspid annulus in patients with low surgical risk.

• #56 Treatment options for severe functional tricuspid regurgitation: indications, techniques and current challenges

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Treatment-options-for-severe-functional-tricuspid-regurgitation-indications-techniques-and-current-challenges

  Concomitant treatment of TR during left-sided heart surgery does not confer an increased risk of postoperative morbidity, mortality or permanent pacemaker requirement. […] According to a recent meta-analysis, concomitant tricuspid valve repair during left-sided valve surgery was associated with a reduction in cardiac-related mortality and improved echocardiographic outcomes for TR after a mean weighted follow-up of six years as compared to cases without concomitant tricuspid valve repair. […] A class IIa (level of evidence: C) recommendation is given for tricuspid valve surgery in patients with mild or moderate functional TR with a dilated tricuspid annulus (i.e., 40 mm or 21 mm/m by 2D echocardiography) undergoing left-sided valve surgery. […] Tricuspid valve surgery may be considered in patients undergoing left-sided valve surgery with mild or moderate secondary tricuspid regurgitation even in the absence of annular dilatation when previous recent right heart failure has been documented.

• #57 Treatment options for severe functional tricuspid regurgitation: indications, techniques and current challenges

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Treatment-options-for-severe-functional-tricuspid-regurgitation-indications-techniques-and-current-challenges

  In addition, the guidelines provide a class IIa (level of evidence: C) recommendation for tricuspid valve surgery in patients with severe TR after previous left-sided surgery if patients are symptomatic, or progressive right ventricular dilatation or dysfunction is evident. […] However, before a decision is made for reoperation on the tricuspid valve in cases of persistent TR after left-sided heart surgery, recurrent left-sided valve dysfunction, severe right or left ventricular dysfunction, and severe pulmonary vascular disease or hypertension have to be ruled out. […] Surgical tricuspid valve repair with annuloplasty is the preferred treatment for functional TR in patients with suitable anatomy, preserved right ventricular function and acceptable surgical risk. […] Tricuspid valve repair is associated with lower perioperative mortality as compared to valve replacement in patients with functional TR and, therefore, is generally the preferred surgical treatment option.

• #58 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811

  The best treatment in each individual case is decided by a multidisciplinary heart team. […] To date, the only evidence from randomized controlled trials is for interventional treatments. These include edge-to-edge repair by means of clipping and interventional tricuspid valve replacement with the Evoque system. […] Severe TR is a serious multifactorial disease which, if left untreated, leads to progressive right heart failure and is associated with a poor prognosis. To prevent irreversible damage to the right heart and the development of secondary organ complications, early outpatient diagnosis with timely referral to an experienced heart valve center is crucial.

• #59 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://www.aerzteblatt.de/archiv/the-diagnosis-and-treatment-of-tricuspid-regurgitation-2963c457-2621-4a6c-9246-a9b5d6475fc5

  Transthoracic echocardiography is the method of choice for detection of the disease. Simple echocardiography with evaluation of leaflet morphology and function including color-coded Doppler sonography and assessment of the right ventricle suffices for initial diagnosis. […] The severity of TR is assessed by means of multiparametric measurements (qualitative, quantitative, and semiquantitative). […] If significant and symptomatic TR persists despite optimal treatment of underlying conditions and medical therapy, one should weigh up whether specific tricuspid valve treatment is indicated. […] The currently prevailing guidelines recommend tricuspid valve surgery, with simultaneous operative treatment of the left heart in the presence of severe TR or dilatation of the tricuspid annulus in patients with low surgical risk. […] To prevent irreversible damage to the right heart and the development of secondary organ complications, early outpatient diagnosis with timely referral to an experienced heart valve center is crucial.

• #60 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Clinical trials and endpoints: […] Because of heterogenous outcomes associated with intervention, clinical staging and scoring systems should integrate TR severity, heart failure severity, and comorbidities. The TRI-SCORE was developed to predict operative mortality for TV surgery, and incorporates clinical data, biomarkers, and echocardiographic parameters. […] Awareness of the importance of TR and its assessment and management are important, including referral of patients to tertiary heart valve centers. […] The authors advocate for a change in the paradigm of TR management; with consideration for early and multimodality imaging-based selective treatment to reduce the risks of irreversible RV damage, organ failure, and residual heart failure.

• #61 Tricuspid Regurgitation – Diagnosis

  https://www.my-connext.com/valvular-diseases/tricuspid/diagnosis?spec=20

  An interactive tool for in-hospital mortality prediction. It is a simple, accurate and dedicated risk-score model to predict outcome after isolated tricuspid valve surgery for severe tricuspid regurgitation at an individual level according to the pre-operative clinical, biological and echocardiographic presentation.

• #62 Tricuspid regurgitation: Management and prognosis – UpToDate

  https://www.uptodate.com/contents/tricuspid-regurgitation-management-and-prognosis

  Tricuspid regurgitation (TR) is a relatively common condition. Since this valve lesion is frequently asymptomatic and may not be detected on physical examination, it is often diagnosed solely by echocardiography. This topic will review the prognosis and management of TR. […] Management of TR is based upon the stage of TR, the cause of TR, the presence and extent of symptoms and signs of heart failure (HF), and the presence and extent of associated abnormalities, including pulmonary hypertension, tricuspid annular dilation, right ventricular (RV) dysfunction, and other valve disease. […] The stage of TR is determined based upon clinical manifestations and cardiac imaging, generally Doppler echocardiography, and, in selected cases, TR severity is quantitated with cardiovascular magnetic resonance imaging. […] The causes of TR are categorized as primary or secondary.

• #63 Tricuspid valve regurgitation | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20120486/

  There are different types of echocardiograms. A standard echocardiogram is called a transthoracic echocardiogram (TTE). It creates pictures of the heart from outside the body. Sometimes, a more-detailed echocardiogram is needed to better see the tricuspid valve. This test is called a transesophageal echocardiogram (TEE). It creates pictures of the heart from inside the body. The type of echocardiogram you have depends on the reason for the test and your overall health. […] Electrocardiogram (ECG or EKG). This quick test records the electrical signals in the heart. It shows how the heart is beating. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Cardiac MRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. Cardiac MRI may help show the severity of tricuspid valve regurgitation. The test also gives details about the lower right heart chamber.

• #64 Mayo Clinic Health Library – Tricuspid valve regurgitation | Swiss Medical Network

  https://www.swissmedical.net/it/healtcare-library/con-20120486

  After testing confirms a diagnosis of tricuspid or other heart valve disease, your healthcare team may tell you the stage of disease. Staging helps determine the most appropriate treatment. […] The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] Tricuspid valve regurgitation treatment may include: Medicines. A heart procedure. Surgery to repair or replace the heart valve. […] Your healthcare professional may suggest medicines to control symptoms of tricuspid valve regurgitation. Medicines also may be used to treat the cause. […] Surgery may be needed to repair or replace a diseased or damaged tricuspid valve.

• #65 Tricuspid Valve Regurgitation | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/triscuspid-valve-regurgitation

  The four stages of tricuspid valve regurgitation include: At-risk: You have risk factors for heart valve disease that require monitoring; Progressive: Mild valve disease doesnt cause symptoms, but may require treatment; Asymptomatic severe: Severe valve disease doesnt cause symptoms, but may require treatment; Symptomatic severe: Severe valve disease causes serious symptoms and may require treatment. […] Mild or trace tricuspid valve regurgitation rarely requires treatment. However, your provider may recommend more frequent heart tests to monitor the condition. Moderate to severe tricuspid valve disease requires treatment to prevent serious heart complications.

• #66 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811

  Background: It is estimated that 6% of persons over age 75 have clinically relevant tricuspid regurgitation (TR). This condition carries a high mortality and is of particular interest because of the recent development of new interventional treatments. […] In the outpatient setting, timely diagnosis by transthoracic echocardiography is crucial. […] Although the relevance of TR is undisputed, the disease is still frequently diagnosed too late, and diagnosis is followed by specific treatment in far fewer than 10% of cases. Early diagnosis and evaluation of treatment options would be indicated in order to prevent manifest heart failure, despite the lack, to date, of evidence from randomized controlled trials to back up this recommendation. […] Transthoracic echocardiography is the method of choice for detection of the disease. Simple echocardiography with evaluation of leaflet morphology and function including color-coded Doppler sonography and assessment of the right ventricle suffices for initial diagnosis.

• #67 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://www.aerzteblatt.de/archiv/the-diagnosis-and-treatment-of-tricuspid-regurgitation-2963c457-2621-4a6c-9246-a9b5d6475fc5

  Background: It is estimated that 6% of persons over age 75 have clinically relevant tricuspid regurgitation (TR). This condition carries a high mortality and is of particular interest because of the recent development of new interventional treatments. […] In the outpatient setting, timely diagnosis by transthoracic echocardiography is crucial. […] Although the relevance of TR is undisputed, the disease is still frequently diagnosed too late, and diagnosis is followed by specific treatment in far fewer than 10% of cases. Early diagnosis and evaluation of treatment options would be indicated in order to prevent manifest heart failure, despite the lack, to date, of evidence from randomized controlled trials to back up this recommendation. […] Diagnosis of clinically significant TR should prompt more detailed exploration at a heart valve center. The tricuspid valve pathology has to be evaluated, the underlying causes of TR have to be identified, and the cardiac and extracardiac implications have to be delineated. The multimodal diagnostic investigations conducted to this end form an essential basis for the subsequent treatment recommendations.

• #68 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811

  Background: It is estimated that 6% of persons over age 75 have clinically relevant tricuspid regurgitation (TR). This condition carries a high mortality and is of particular interest because of the recent development of new interventional treatments. […] In the outpatient setting, timely diagnosis by transthoracic echocardiography is crucial. […] Although the relevance of TR is undisputed, the disease is still frequently diagnosed too late, and diagnosis is followed by specific treatment in far fewer than 10% of cases. Early diagnosis and evaluation of treatment options would be indicated in order to prevent manifest heart failure, despite the lack, to date, of evidence from randomized controlled trials to back up this recommendation. […] Transthoracic echocardiography is the method of choice for detection of the disease. Simple echocardiography with evaluation of leaflet morphology and function including color-coded Doppler sonography and assessment of the right ventricle suffices for initial diagnosis.

• #69 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Clinical trials and endpoints: […] Because of heterogenous outcomes associated with intervention, clinical staging and scoring systems should integrate TR severity, heart failure severity, and comorbidities. The TRI-SCORE was developed to predict operative mortality for TV surgery, and incorporates clinical data, biomarkers, and echocardiographic parameters. […] Awareness of the importance of TR and its assessment and management are important, including referral of patients to tertiary heart valve centers. […] The authors advocate for a change in the paradigm of TR management; with consideration for early and multimodality imaging-based selective treatment to reduce the risks of irreversible RV damage, organ failure, and residual heart failure.

• #70 Treatment options for severe functional tricuspid regurgitation: indications, techniques and current challenges

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Treatment-options-for-severe-functional-tricuspid-regurgitation-indications-techniques-and-current-challenges

  The prevalence of coexisting moderate-to-severe TR is between 11% and 26% in patients undergoing transcatheter aortic valve replacement (TAVR) for native aortic valve stenosis, and a reduction in echocardiographic TR grade has been observed in 15% to 50% following TAVR in these patients. […] Current guidelines for the management of valvular heart disease provide recommendations to guide surgical interventions in primary and secondary TR. […] The optimal timing of surgical intervention for TR remains controversial. […] However, delayed surgery must be avoided given the risk of irreversible right ventricular damage, organ failure and poor results of later surgical intervention. […] The 2017 ESC/EACTS Guidelines for the management of valvular heart disease provide a class I (level of evidence: C) recommendation for tricuspid valve surgery in patients with severe functional TR undergoing left-sided valve surgery.

• #71 Treatment options for severe functional tricuspid regurgitation: indications, techniques and current challenges

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Treatment-options-for-severe-functional-tricuspid-regurgitation-indications-techniques-and-current-challenges

  The prevalence of coexisting moderate-to-severe TR is between 11% and 26% in patients undergoing transcatheter aortic valve replacement (TAVR) for native aortic valve stenosis, and a reduction in echocardiographic TR grade has been observed in 15% to 50% following TAVR in these patients. […] Current guidelines for the management of valvular heart disease provide recommendations to guide surgical interventions in primary and secondary TR. […] The optimal timing of surgical intervention for TR remains controversial. […] However, delayed surgery must be avoided given the risk of irreversible right ventricular damage, organ failure and poor results of later surgical intervention. […] The 2017 ESC/EACTS Guidelines for the management of valvular heart disease provide a class I (level of evidence: C) recommendation for tricuspid valve surgery in patients with severe functional TR undergoing left-sided valve surgery.

• #72 Treatment options for severe functional tricuspid regurgitation: indications, techniques and current challenges

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Treatment-options-for-severe-functional-tricuspid-regurgitation-indications-techniques-and-current-challenges

  Concomitant treatment of TR during left-sided heart surgery does not confer an increased risk of postoperative morbidity, mortality or permanent pacemaker requirement. […] According to a recent meta-analysis, concomitant tricuspid valve repair during left-sided valve surgery was associated with a reduction in cardiac-related mortality and improved echocardiographic outcomes for TR after a mean weighted follow-up of six years as compared to cases without concomitant tricuspid valve repair. […] A class IIa (level of evidence: C) recommendation is given for tricuspid valve surgery in patients with mild or moderate functional TR with a dilated tricuspid annulus (i.e., 40 mm or 21 mm/m by 2D echocardiography) undergoing left-sided valve surgery. […] Tricuspid valve surgery may be considered in patients undergoing left-sided valve surgery with mild or moderate secondary tricuspid regurgitation even in the absence of annular dilatation when previous recent right heart failure has been documented.

• #73 Treatment options for severe functional tricuspid regurgitation: indications, techniques and current challenges

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Treatment-options-for-severe-functional-tricuspid-regurgitation-indications-techniques-and-current-challenges

  In addition, the guidelines provide a class IIa (level of evidence: C) recommendation for tricuspid valve surgery in patients with severe TR after previous left-sided surgery if patients are symptomatic, or progressive right ventricular dilatation or dysfunction is evident. […] However, before a decision is made for reoperation on the tricuspid valve in cases of persistent TR after left-sided heart surgery, recurrent left-sided valve dysfunction, severe right or left ventricular dysfunction, and severe pulmonary vascular disease or hypertension have to be ruled out. […] Surgical tricuspid valve repair with annuloplasty is the preferred treatment for functional TR in patients with suitable anatomy, preserved right ventricular function and acceptable surgical risk. […] Tricuspid valve repair is associated with lower perioperative mortality as compared to valve replacement in patients with functional TR and, therefore, is generally the preferred surgical treatment option.

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