ECHO - Tricuspid and Pulmonic Valve Flashcards
Leaflets of the Tricuspid Valve?
- Anterior
- Septal
- Posterior/inferior
Cut off for enlarged Tricuspid annulus?
Diameter of >40mm/ 21mm/m2
measure in apical 4 chamber view
tricuspid valve Leaflet seen a particular view?
anterior leaflet in RV inflow view
posterior/inferior leaflet in PSAX view
Septal leaflet in 4cv
tricuspid valve Leaflet seen RV inflow view?
anterior leaflet, see pic
tricuspid valve Leaflet seen PSAX view?
posterior/inferior leaflet
tricuspid valve Leaflet seen apical 4chamber view?
septal leaflet
TR is important due to increase mortality associated with it.
mortality risk is independent of:
- RV dysfunction
- RVSP
- afib
- LVEF
in Tricuspid Stenosis, what is considered as severe in terms of pressure gradient?
> 5-7mmhg
Valve area of ≤1cm2 by CE
(make sure that no more than mild TR)
post operative mortality for isolated TR surgery is high
see pic
Mechanism of TR in terms , part 1
see pic
Mechanism of TR in terms , part 2 - etiology
see pic
Features of severe TR
Criteria for severe TR
Valve Hemodynamics:
- Central jet >50% of RA
- Vena contracta width of >0.7cm
- ERO >0.4cm
- R volume >45ml
- dense CW signal with dagger shape
- Hepatic vein systolic lfow reversal
What is Hepatic vein systolic flow reversal
see pic
Importance of VC in TR
see pic
When to intervene for TR?
Class I only is if there is concomitant Left sided surgery
Leaflets of Pulmonary valve
3 leaflets: anterior, left and right
which branch of MPA courses behind the ascending aorta?
RPA
Grading for Pulmonary Stenosis
see pic
T/F: RVSP does not always equal to PASP
true
particularly in pulmonic stenosis
Severity for pulmonic regurgitation?
based on color doppler
see pic
What is Carcinoid Heart Disease?
only affects right heart
vasoactive substances release from tumors arising from the GI tract
Severity for pulmonic regurgitation?
based on CW doppler
see pic
Effects of Carcinoid Heart disease to the right side of the heart?
severe TR, severe PR and RV dysfunction
***CWD on PV- dense CWD signal with rapid PHT and equalization before the end of diastole
