Tricuspid Regurgitation
Evaluate TR severity and explore intervention pathways. TR is frequently encountered in perioperative echocardiography — its clinical impact depends on mechanism, right-heart adaptation, and context.
Assess TR severity
Grade TR severity using ACC/AHA 2020 integrated criteria: qualitative grade, vena contracta width, PISA EROA, regurgitant volume, hepatic vein systolic flow, and CW Doppler contour.
TR Intervention Navigator
Evaluate intervention pathways for significant TR based on mechanism, right-heart function, and clinical context. Includes surgical, TEER, and device lead considerations.
Learn TR
- Why TR Vmax does not equal TR severityArticle
- Why hepatic vein systolic reversal mattersArticle
- TR mechanisms: why each drives a different pathwayArticle
- Device lead TR: why the valve team is essentialArticle
- TR timing: evaluate before RV function and organ damage worsenArticle
- TR at left-sided surgery: concomitant evaluationArticle
- TR before noncardiac surgery: when to be concernedArticle
TR cases
Clinical context
Mechanism drives management
Primary structural TR (leaflet pathology) and secondary TR (RV dilation, atrial functional, device lead) have fundamentally different management pathways. Identify mechanism before applying intervention criteria.
Right-heart adaptation matters
TR severity alone does not determine urgency. RV size, function, TAPSE, IVC plethora, and congestion signs contextualize the hemodynamic burden and guide clinical decisions.
TR Vmax is not a severity signal
TR Vmax reflects the RV-RA pressure gradient and is used for PASP estimation. In severe TR, pressure equalization reduces the gradient — low TR Vmax does not exclude severe TR, and high TR Vmax does not confirm it.