Multimodality Imaging of the Tricuspid Valve and Right Heart Anatomy

Khalique, Omar; Cavalcante, João L.; Shah, Dipan J.; Guta, A C; Zhan, Yang; Piazza, Nicolò; Muraru, Denisa

doi:10.1016/j.jcmg.2019.01.006

Cited by 97 publications

(69 citation statements)

References 82 publications

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“…The healthy tricuspid annulus has a three-dimensional saddleshaped elliptical geometry (15,(21)(22)(23). Its anterior and posterior portions are muscular, whereas the septal part is more fibrous, which explains predominant antero-posterior annular dilation as well as the spherical and planar shape of the annulus in patients with severe functional TR (11,24).…”

Section: Morphology and Anatomical Relationsmentioning

confidence: 99%

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Winkel

Brugger

Khalique

et al. 2020

Front. Cardiovasc. Med.

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With the emergence of transcatheter solutions for the treatment of tricuspid regurgitation (TR) increased attention has been directed to the once neglected tricuspid valve (TV) complex. Recent studies have highlighted new aspects of valve anatomy and TR etiology. The assessment of valve morphology along with quantification of regurgitation severity and RV function pose several challenges to cardiac imagers guiding transcatheter valve procedures. This review article aims to give an overview over the role of modern imaging modalities during assessment and treatment of the TV.

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Section: Morphology and Anatomical Relationsmentioning

confidence: 99%

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Winkel

Brugger

Khalique

et al. 2020

Front. Cardiovasc. Med.

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“…Three-dimensional techniques such as three-dimensional echocardiography, cardiovascular magnetic resonance, or multislice computed tomography are powerful tools for assessing the TV annulus, as well as the RV and LV size and global function. 39 The current echocardiographic criteria for grading TR only consider three grades of severity: mild, moderate, and severe. 40 In the SCOUT trial, 41 despite the severity of TR reduced from 'severe' to 'severe', the equivalent quantitative reduction of a 'grade' of TR was associated with an increase in stroke volume and improved quality of…”

Section: Imaging For Decision-making In Patients With Tricuspid Regurmentioning

confidence: 99%

Uncertainties and challenges in surgical and transcatheter tricuspid valve therapy: a state-of-the-art expert review

Chang

Veen

Hahn

et al. 2019

European Heart Journal

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Tricuspid regurgitation (TR) is a frequent and complex problem, commonly combined with left-sided heart disease, such as mitral regurgitation. Significant TR is associated with increased mortality if left untreated or recurrent after therapy. Tricuspid regurgitation was historically often disregarded and remained undertreated. Surgery is currently the only Class I Guideline recommended therapy for TR, in the form of annuloplasty, leaflet repair, or valve replacement. As growing experience of transcatheter therapy in structural heart disease, many dedicated transcatheter tricuspid repair or replacement devices, which mimic well-established surgical techniques, are currently under development. Nevertheless, many aspects of TR are little understood, including the disease process, surgical or interventional risk stratification, and predictors of successful therapy. The optimal treatment timing and the choice of proper surgical or interventional technique for significant TR remain to be elucidated. In this context, we aim to highlight the current evidence, underline major controversial issues in this field and present a future roadmap for TR therapy.

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“…STR is the most common form of TR, occurring in 75% of cases. There is usually dilatation of the annulus, followed by changes in RV geometry with displacement of the papillary muscles and leaflet tethering [3, 9, 10].…”

Section: Tricuspid Regurgitation (Tr) and Its Clinical Impactmentioning

confidence: 99%

“…The coronary sinus is anatomically close to the posterior septal commissure. The right coronary artery is related to the anterior and posterior portions of the annulus [1, 3].…”

Section: Introductionmentioning

confidence: 99%

The Forgotten, Not Studied or Not Valorized Tricuspid Valve: The Transcatheter Revolution Is Coming

Oliveira

Oliveira²

2019

Cardiol Res

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The tricuspid valve (TV) has been known as the forgotten valve. However, considering recent information from scientific studies, this nomenclature may need to be adjusted for the valve, which also needs to be better studied and understood. For decades, tricuspid regurgitation (TR) was not fully appreciated and was never the priority. However, studies have revealed that such pathology is related to a possible negative impact on prognosis of patients. Severe TR is a predictor of higher mortality. For the treatment of TR, repair or valve replacement can be performed. Repair techniques can be performed on the annulus (suture annuloplasty or ring implant), on the leaflets (e.g. triangular resection), on the cords (transfers or new cords) and on the papillary muscles (e.g. sliding technique). The anatomical characteristics of the TV determine the repair technique to be used. In some cases, valve repair is not possible and/or not indicated and valve replacement is selected based on the strategy. Nowadays transcatheter therapies have been used and studied. The main transcatheter strategies for the treatment of TR are based on reduction of the annulus (Cardioband, Trialign, TriCinch, Millipede and TRAIPTA), improvement of the leaflet coaptation (Mitraclip, FORMA device, PASCAL system, and TV occluder), reduction of the reflux for the vena cava system (Tric valve and Sapien valve implant), and valve implants (Navigate, Trisol, Sapien, Melody). In this context, there are still other devices (such as Tricentro, Pasta, etc.) being developed and tested throughout several phases of research. In the future, improved knowledge of the TV and the evolution of transcatheter treatments will alter the history of the TV. The transcatheter revolution is coming!

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Multimodality Imaging of the Tricuspid Valve and Right Heart Anatomy

Cited by 97 publications

References 82 publications

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Uncertainties and challenges in surgical and transcatheter tricuspid valve therapy: a state-of-the-art expert review

The Forgotten, Not Studied or Not Valorized Tricuspid Valve: The Transcatheter Revolution Is Coming

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