Author + information
- Received June 18, 2018
- Revision received September 17, 2018
- Accepted September 20, 2018
- Published online March 4, 2019.
- Edgard A. Prihadi, MDa,b,
- Victoria Delgado, MD, PhDa,
- Martin B. Leon, MD, PhDc,
- Maurice Enriquez-Sarano, MD, PhDd,
- Yan Topilsky, MD, PhDe and
- Jeroen J. Bax, MD, PhDa,∗ ()
- aDepartment of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
- bDepartment of Cardiology, ZNA Middelheim Hospital, Antwerpen, Belgium
- cDepartment of Cardiology, Columbia University Medical Center, New York, New York
- dCardiovascular Diseases Division, Mayo Clinic, Rochester, Minnesota
- eDepartment of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv, Israel
- ↵∗Address for correspondence:
Dr. Jeroen J. Bax, Department of Cardiology, Leiden University Medical Center, Albinusdreef 2 2300 RC Leiden, the Netherlands.
Tricuspid regurgitation (TR) is classified according to different morphologic types based on the underlying mechanisms: primary, secondary, and isolated TR. Primary TR is caused by an anatomical abnormality of the tricuspid valve apparatus. Secondary TR is caused by dilation of the tricuspid valve annulus, related to right ventricular (RV), or right atrial remodeling and increased RV pressures (often secondary to left-sided heart disease). Isolated TR can exist in patients without increased RV pressures and is frequently associated with atrial fibrillation. Two-dimensional echocardiography plays a pivotal role in the assessment of the etiology and severity of TR. Views from 3-dimensional techniques have significantly increased the understanding of the pathophysiology of each morphologic type of TR (leaflet damage, annular dilation, and distinct patterns of right-heart remodeling). The following review will describe the etiology, anatomical and functional characteristics, and outcomes of each morphologic type of TR, and furthermore addresses challenging pitfalls in the referral for tricuspid valve intervention.
The Department of Cardiology of the Leiden University Medical Center has received research grants from Boston Scientific, Medtronic, Biotronik, Edwards Lifesciences, and GE Healthcare. Dr. Delgado has received personal fees from Abbott Vascular. Dr. Enriquez-Sarano has received grants from Edwards LLC. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 18, 2018.
- Revision received September 17, 2018.
- Accepted September 20, 2018.
- 2019 American College of Cardiology Foundation
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