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Table of Contents
VIDEO COMMENTARY  
Year : 2015  |  Volume : 18  |  Issue : 4  |  Page : 613-615
Video commentary on trans-esophageal echocardiography of tricuspid valve


Department of Cardiac Anaesthesia, CNC, AIIMS, New Delhi, India

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Date of Web Publication1-Oct-2015
 

How to cite this article:
Taneja S, Singh SP, Malhotra P. Video commentary on trans-esophageal echocardiography of tricuspid valve. Ann Card Anaesth 2015;18:613-5

How to cite this URL:
Taneja S, Singh SP, Malhotra P. Video commentary on trans-esophageal echocardiography of tricuspid valve. Ann Card Anaesth [serial online] 2015 [cited 2021 Apr 22];18:613-5. Available from: https://www.annals.in/text.asp?2015/18/4/613/166489



   Trans-Esophageal Echocardiography Views for Tricuspid Valve Imaging Top





   Tricuspid regurgitation Top


  • Functional tricuspid regurgitation (TR) can also be observed in a variety of diseases producing pulmonary hypertension and/or right ventricular (RV) dysfunction [Figure 5]
    Figure 5: Color Doppler showing regurgitation jet

    Click here to view
  • The most important characteristics of functional TR are its variability in a given patient. Two-dimensional findings of tricuspid regurgitation [Figure 6].
    Figure 6: Measurement of tricuspid annulus in ME 4 chamber view

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Two dimensional echocardiography

  • Leaflets: Thickened, prolapse, flail, non coapting.
  • Annulus: Tricuspid annulus [Figure 8] dilated when >36 mm septolateral dimension (4C view) or 2.1 cm/m 2
  • Color Doppler: Turbulent retrograde flow, mosaic or red; vena contracta [Figure 7], proximal isovelocity surface area radius
    Figure 7: Measurement of vena contracta on color Doppler in RV inflow-outflow view

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    Figure 8: Measurement of tricuspid annulus in ME 4 chamber view

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  • Pulsed-wave: Increased E wave velocity >1 m/s, hepatic vein flow reversal
  • View to measure RV systolic pressure is RV inflow - outflow view and pulmonary artery systolic pressure in not an index for TR severity [Figure 9].
    Figure 9: Measurement of Pulmonary artery systolic pressure in RV inflow outflow view

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   Tricuspid stenosis Top


Two-dimensional findings

Thickened leaflets, decreased mobility, tethered tips, right atrial enlarged, dilated inferior vena cava [Figure 10].
Figure 10: ME 4 chamber view showing Tricuspid Stenosis

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  • Color Doppler - turbulent flow
  • Continuous wave Doppler - peak E velocity >1 m/s.


Grading of tricuspid stenosis

Mean gradient < 2mm Hg - Mild stenosis

Mean gradient 2-6mm Hg - Moderate stenosis

Mean gradient >6 mm Hg - Severe stenosis.

Tricuspid stenosis on three-dimensional trans-esophageal echocardiography [Figure 11].
Figure 11: 3 dimensional echocardiography showing tricuspid stenosis

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Correspondence Address:
Dr. Sarvesh Pal Singh
Department of Cardiac Anaesthesia, CNC, AIIMS, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.166489

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11]



 

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