Tricuspid regurgitation cardiac catheterization

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2] Fatimo Biobaku M.B.B.S [3] Vamsikrishna Gunnam M.B.B.S [4]

Overview

Cardiac catheterization may be useful in the evaluation of tricuspid regurgitation when the results of the non-invasive testing are insufficient.

Cardiac catheterization

Cardiac catheterization might be performed when there is lack of consistency between the clinical findings and the results of the non-invasive testing in order to rule out cardiac etiologies of pulmonary hypertension as the cause of the patient’s symptoms.^[1]^[2]
Right ventriculography and hemodynamic assessment by cardiac catheterization are used to assess the function of the right ventricle and estimate the severity of the valvular regurgitation.^[3]
Left ventriculography may be helpful in assessment of causes of secondary TR.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[4]

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines^[4]

Recommendations for Diagnosis of TR

Class IIa
2. In patients with TR, invasive measurement of the cardiac index, right-sided diastolic pressures, pulmonary artery pressures, and pulmonary vascular resistance, as well as right ventriculography, can be useful when clinical and noninvasive data are discordant or inadequate. (Level of Evidence: C-LD)

2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary[1]

2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary^[1]

Class IIa
“1. Invasive measurement of pulmonary artery pressures and pulmonary vascular resistance can be useful in patients with TR when clinical and noninvasive data regarding their values are discordant. (Level of Evidence: C)”

2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) [5]

2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) ^[5]

Adolescents (DO NOT EDIT) ^[5]

Class IIa
“1. If there is a symptomatic atrial arrhythmia, an electrophysiology study can be useful for the initial evaluation of adolescent and young adult patients with TR. (Level of Evidence: C)”

References

↑ ^1.0 ^1.1 Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). “2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines”. Circulation. doi:10.1161/CIR.0000000000000029. PMID 24589852.
↑ Nishimura RA, Carabello BA (2012). “Hemodynamics in the cardiac catheterization laboratory of the 21st century”. Circulation. 125 (17): 2138–50. doi:10.1161/CIRCULATIONAHA.111.060319. PMID 22547754.
↑ Yousof AM, Shafei MZ, Endrys G, Khan N, Simo M, Cherian G (1985). “Tricuspid stenosis and regurgitation in rheumatic heart disease: a prospective cardiac catheterization study in 525 patients”. Am Heart J. 110 (1 Pt 1): 60–4. doi:10.1016/0002-8703(85)90515-0. PMID 4013991.
↑ Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F; et al. (2021). “2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines”. Circulation. 143 (5): e72–e227. doi:10.1161/CIR.0000000000000923. PMID 33332150 Check |pmid= value (help).
↑ ^5.0 ^5.1 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). “2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter |month= ignored (help)

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[pmid24589852-1] 1.0 ^1.1 Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). “2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines”. Circulation. doi:10.1161/CIR.0000000000000029. PMID 24589852.

[pmid22547754-2] Nishimura RA, Carabello BA (2012). “Hemodynamics in the cardiac catheterization laboratory of the 21st century”. Circulation. 125 (17): 2138–50. doi:10.1161/CIRCULATIONAHA.111.060319. PMID 22547754.

[pmid4013991-3] Yousof AM, Shafei MZ, Endrys G, Khan N, Simo M, Cherian G (1985). “Tricuspid stenosis and regurgitation in rheumatic heart disease: a prospective cardiac catheterization study in 525 patients”. Am Heart J. 110 (1 Pt 1): 60–4. doi:10.1016/0002-8703(85)90515-0. PMID 4013991.

[pmid33332150-4] Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F; et al. (2021). “2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines”. Circulation. 143 (5): e72–e227. doi:10.1161/CIR.0000000000000923. PMID 33332150 Check |pmid= value (help).

[pmid18820172-5] 5.0 ^5.1 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). “2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter |month= ignored (help)

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