Morphological Assessment of the Tricuspid Apparatus and Grading Regurgitation Severity in Patients With Functional Tricuspid Regurgitation

Badano, Luigi P.; Hahn, Rebecca T.; Rodríguez‐Zanella, Hugo; Araiza-Garaygordobil, Diego; Ochoa-Jimenez, Roberto Carlos; Muraru, Denisa

doi:10.1016/j.jcmg.2018.09.029

Cited by 81 publications

(74 citation statements)

References 64 publications

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“…Transthoracic echocardiography and transesophageal echocardiography (TEE) represents the primary imaging modality used for TR detection, identification of mechanism and grading, evaluation of feasibility for different percutaneous interventions, intraprocedural guidance, and follow-up ( 33 , 34 ). Besides its well-established role in TR identification and grading ( 35 ), echocardiography also enables a comprehensive assessment of right ventricular dimensions and function, estimation of pulmonary artery pressures, and evaluation of left heart structures to be undertaken. These additional evaluations are fundamental in the pre-procedural screening of candidates for TTVIs ( 34 ).…”

Section: Cardiac Imaging Is the Key For The Future Of Transcatheter Tmentioning

confidence: 99%

Future Perspectives in Percutaneous Treatment of Tricuspid Regurgitation

Mangieri

Pagnesi

Regazzoli

et al. 2020

Front. Cardiovasc. Med.

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Tricuspid regurgitation (TR) has a not negligible prevalence and its severity is correlated with poorer outcomes. However, surgical options are rarely offered to these patients because of their high surgical risk. Given that medical therapy plays a limited role in the management of these patients, there is an increasing clinical need for transcatheter treatment options. Although, transcatheter tricuspid valve interventions (TTVIs) are still at an early stage, emerging data suggests their clinical effectiveness and safety, with preliminary results highlighting the potential benefits of transcatheter treatments over medical therapy. In this review, we highlight the challenges and future directions of current and emerging technologies dedicated to the treatment of TR along with an analysis of the next steps required in future clinical trials and studies dedicated to the treatment of the forgotten valve.

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Section: Cardiac Imaging Is the Key For The Future Of Transcatheter Tmentioning

confidence: 99%

Future Perspectives in Percutaneous Treatment of Tricuspid Regurgitation

Mangieri

Pagnesi

Regazzoli

et al. 2020

Front. Cardiovasc. Med.

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“…Typical causes of primary TR include myxomatous disease, congenital abnormalities such as Ebstein's anomaly (Figure 2C,D, Movie ) characterized by apical displacement of the leaflets (septal > posterior > anterior), 12 carcinoid heart disease (Figure 2E,F), injury from myocardial biopsy or pacemaker lead insertion (Figure 2G,H, Movie ), lupus, sarcoidosis, radiation, rheumatic heart disease, and endocarditis 13 . Secondary TR is much more common and is thought to affect approximately 1.6 million individuals in the US 14 . This is caused by RV and TV anterior‐posterior annular dilatation resulting in distortion of the saddle‐shaped ellipsoid annulus into a circular‐shaped orifice.…”

Section: Tricuspid Valve Pathologymentioning

confidence: 99%

“…Additionally, 3D TTE can provide excellent images of all three leaflets of the TV simultaneously and is useful to identify tricuspid valve pathology 14 . In many cases, 3D TTE may provide similar or better assessment of the tricuspid apparatus due to its anterior location, which is in closer proximity to the chest wall than the esophagus and can be viewed in standard imaging planes.…”

Section: Echo Imaging Of the Tricuspid Valvementioning

confidence: 99%

“…The 3D imaging with color Doppler can also be used to planimeter the area of the vena contracta, which may be a more accurate method to quantify TR since the regurgitant orifice may not be circular as assumed by the PISA method (Figure 10). 14 The limitation of quantification using 3D vena contracta area is that proposed cutoff values for severe TR are quite variable (0.36 cm 2 to >0.75 cm 2 ) likely due to a lack of a true gold standard 22 . Hahn and Zamorano have proposed a new classification system for very severe TR which includes the additional categories of massive and torrential.…”

Section: Assessment Of Tricupsid Regurgitationmentioning

confidence: 99%

“…New advances in the 3D assessment of TR are on the horizon as new software is being developed to allow tracking of color Doppler flow during the cardiac cycle by using real‐time 3D echo color flow acquisitions. Acquiring 3D color flow at the tricuspid and pulmonic valves over multiple cardiac cycles may allow for the accurate measurement of TR volume separate from the geometric assumptions used in current quantitative methods 14 …”

Section: Assessment Of Tricupsid Regurgitationmentioning

confidence: 99%

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Three‐dimensional echocardiography for the assessment of the tricuspid valve

2020

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Tricuspid valve pathology is increasingly recognized as an important contributor to patient morbidity. Accordingly, interest in transcatheter interventions for tricuspid valve disease has continued to grow. Echocardiographic imaging of the tricuspid valve has therefore become an integral component of patient assessment and the essential imaging modality for interventional procedures. The need for improved tricuspid valve imaging has highlighted the variability in tricuspid valve anatomy and the difficulties of using two-dimensional (2D) echocardiography alone to determine the location and type of tricuspid valve disease. Here, three-dimensional (3D) imaging using tools such as biplane imaging, multiplanar reconstruction and live 3D acquisition allow a more accurate and efficient evaluation of the tricuspid valve. The 3D imaging of the tricuspid valve is often focused on transesophageal echocardiography, but the more anterior location of the tricuspid valve also lends itself to assessment with transthoracic echocardiography.In this review, we will examine how 3D imaging can complement and enhance the information obtained from 2D echocardiography, and present novel applications for the quantitation of valvular disease and its utility in intraprocedural imaging. K E Y W O R D Scardiac imaging, three-dimensional echocardiography, tricuspid valve

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Epidemiology, pathophysiology, diagnosis and management of chronic right‐sided heart failure and tricuspid regurgitation. A clinical consensus statement of the Heart Failure Association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC

Adamo,

Chioncel,

Pagnesi

et al. 2024

European J of Heart Fail

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Right‐sided heart failure and tricuspid regurgitation are common and strongly associated with poor quality of life and an increased risk of heart failure hospitalizations and death. While medical therapy for right‐sided heart failure is limited, treatment options for tricuspid regurgitation include surgery and, based on recent developments, several transcatheter interventions. However, the patients who might benefit from tricuspid valve interventions are yet unknown, as is the ideal time for these treatments given the paucity of clinical evidence. In this context, it is crucial to elucidate etiology and pathophysiological mechanisms leading to right‐sided heart failure and tricuspid regurgitation in order to recognize when tricuspid regurgitation is a mere bystander and when it can cause or contribute to heart failure progression. Notably, early identification of right heart failure and tricuspid regurgitation may be crucial and optimal management requires knowledge about the different mechanisms and causes, clinical course and presentation, as well as possible treatment options.The aim of this clinical consensus statement is to summarize current knowledge about epidemiology, pathophysiology and treatment of tricuspid regurgitation in right‐sided heart failure providing practical suggestions for patient identification and management.This article is protected by copyright. All rights reserved.

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Morphological Assessment of the Tricuspid Apparatus and Grading Regurgitation Severity in Patients With Functional Tricuspid Regurgitation

Cited by 81 publications

References 64 publications

Future Perspectives in Percutaneous Treatment of Tricuspid Regurgitation

Future Perspectives in Percutaneous Treatment of Tricuspid Regurgitation

Three‐dimensional echocardiography for the assessment of the tricuspid valve

Epidemiology, pathophysiology, diagnosis and management of chronic right‐sided heart failure and tricuspid regurgitation. A clinical consensus statement of the Heart Failure Association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC

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