Anatomic Relationship of the Complex Tricuspid Valve, Right Ventricle, and Pulmonary Vasculature A Review

Rebecca T. Hahn*, Aaron B. Waxman, Paolo Denti, Tammo Delhaas

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Citations (Web of Science)

Abstract

IMPORTANCE Severe functional or secondary tricuspid regurgitation (TR) is associated with poor long-term outcomes in natural history studies as well as specific disease states. An understanding of the physiologic causes of the TR is lacking precluding a systematic approach to treatment.

OBSERVATIONS The complex anatomic relationship between the tricuspid valve apparatus and structure of the right side of the heart lends insight into the functional changes seen with secondary TR. The association of these changes with changes in pulmonary vascular hemodynamics can lead to a cascade of events that result in disease progression.

CONCLUSIONS AND RELEVANCE Appreciating the role of pulmonary vascular hemodynamics on right ventricular and tricuspid valve morphology and function improves our understanding of the pathophysiology of secondary TR. The limitations of current therapeutic approaches for secondary TR have stimulated interest in improving outcomes with this morbid disease. Changes in timing or approach to intervention require a more comprehensive understanding of the pathophysiology.

Original languageEnglish
Pages (from-to)478-487
Number of pages10
JournalJAMA Cardiology
Volume4
Issue number5
DOIs
Publication statusPublished - May 2019

Keywords

  • HEART-FAILURE ASSOCIATION
  • REAL-TIME
  • EUROPEAN-SOCIETY
  • ARTERY PRESSURE
  • DOPPLER-ECHOCARDIOGRAPHY
  • NONINVASIVE ESTIMATION
  • MAGNETIC-RESONANCE
  • CONTRACTILE FUNCTION
  • ANNULAR DILATATION
  • POSITION STATEMENT

Cite this