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Echo > Tricuspid Valve > Flashcards

Tricuspid Valve Flashcards

1
Q

Apical 4 chamber leaflets TV

A

Anterior, septal

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2
Q

Parasternal RV inflow leaflets TV

A

Septal, anterior

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3
Q

Parasternal short leaflets TV

A

Posterior, septal/anterior

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4
Q

Causes of tricuspid stenosis

A

Rheumatic
Congenital
Carcinoid
Impedance to flow by another structure

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5
Q

Normal MG TV

A

<2 mm Hg

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6
Q

Severe MG TV stenosis

A

> 5-7 mm Hg

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7
Q

Severe PHT TV stenosis

A

> = 190 ms

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8
Q

TV area eq using PHT

A

190/PHT

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9
Q

Do not rely on PHT for TV if

A

RV myocardial disease or significant PR

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10
Q

Severe anatomy TS

A

Thickened, calcified leaflets

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11
Q

Severe TS hemodynamic criteria

A

MG > 5
PHT >= 190
Valve area <= 1

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12
Q

Severe TS consequences

A

RA enlargement
Dilated IVC
RV normal unless other path

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13
Q

TS indication for intervention

A

Severe + symptoms -> valve replacement

Don’t perform valvuloplasty b/c usually have TR

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14
Q

Severe TR Vena contracta

A

> = 7 mm

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15
Q

TR PISA equation for Flow

A

Flow = 2 pi * R2 * Vr * alpha/180

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16
Q

Severe TR ERO

A

40

17
Q

Severe TR Rvol

A

45

18
Q

Severe TR anatomy

A

Flail or distorted leaflets

Annular dilatation

19
Q

Severe TR hemodynamics

A 
Broad jet of color flow, area >= 10 cm2
Vena contracta >= 7mm
Dense dagger shaped / triangular doppler signal
Hepatic vein systolic reversal
ERO >= 40, RVOL >= 45
20
Q

Severe TR consequences

A

RA and RV enlargement

Dilated IVC

21
Q

PASP not equal to RVSP

A

Pulmonary stenosis
Severe PR
Severe TR

22
Q

Primary TR intervention indication

A

Severe + symptoms or progressive RVE / dysfunction

23
Q

Secondary TR intervention indication

A

Severe + symptoms or progressive RVE / dysfunction + can fix cause

24
Q

Severe TR + severe MR intervention

A

Fix TV with MV

25
Q

Isolated MV prolapse + TR

A

clinically silent, non-severe TR rarely progresses

26
Q

TR + PAH treatment

A

PAH therapy +/- transplant

27
Q

Device related TR characteristics

A

Perforation or flail rare
Apparatus entrapment
Adherence of leaflet to lead
Prefer TV replacement over repositioning of lead

28
Q

Gerbode defect

A

Communication between RA and LV, may encompass TV leaflets

29
Q

Rheumatic TV appearance

A

Thickening and doming of valve in diastole

30
Q

Mean PAP using PR

A

Mean = 4 (PI V max)^2 + RAP

31
Q

Diastolic PAP using PR

A

4 (PI end diastolic velocity)^2 + RAP

32
Q

Ebstein anomaly associated with

A

WPW / accessory pathways
Severe TR
Right sided HF
ASDs

33
Q

Surgery of choice for Ebstein anomaly

A

Tricuspid repair

Depends on size and functionality of RV

Echo (30 decks)

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