Tricuspid stenosis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mohammed Salih, M.D. Syed Musadiq Ali M.B.B.S.[2] Aditya Ganti M.B.B.S. [3]

Overview

Tricuspid stenosis (TS) staging sections into categories A, B, C, D. Stages C (without symptoms) and D (with symptoms). When valve and/or chordal thickening and calcification are evident, there are additional findings indicative of severe TS, for example, pressure gradient greater than or equal to 5 mm Hg, pressure half-time greater than or equal to 190 milliseconds, valve area less than or equal to 1.0 cm^2, associated moderate right atrial enlargement, and inferior vena cava dilatation.

Classification

Tricuspid stenosis (TS) is staged based on the valve anatomy and hemodynamics, and the hemodynamic consequences. No criteria for Stage A or B were included in the 2014 American Heart Association/American College of Cardiology valve guidelines. Stage C is defined as severe TS without symptoms. Stage D is defined as severe TS with symptoms.^[1]^[2]

Stage	Definition	Valve anatomy	Valve hemodynamics	Hemodynamic consequences	Symptoms
C, D	Severe TS	Thickened, distorted, calcified leaflets	T ½ ≥190 ms  Valve area ≤1.0 cm2	Right atrial / Inferior vena cava enlargement	Stage C-No symptoms Stage D-Symptoms variable and dependent on the severity of associated valve disease and degree of obstruction

References

↑ 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: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines”. J Am Coll Cardiol. 63 (22): e57–185. doi:10.1016/j.jacc.2014.02.536. PMID 24603191.
↑ Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P.; Iung, Bernard; Otto, Catherine M.; Pellikka, Patricia A.; Quiñones, Miguel (2009). “Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice”. Journal of the American Society of Echocardiography. 22 (1): 1–23. doi:10.1016/j.echo.2008.11.029. ISSN 0894-7317.

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[pmid24603191-1] 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: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines”. J Am Coll Cardiol. 63 (22): e57–185. doi:10.1016/j.jacc.2014.02.536. PMID 24603191.

[BaumgartnerHung2009-2] Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P.; Iung, Bernard; Otto, Catherine M.; Pellikka, Patricia A.; Quiñones, Miguel (2009). “Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice”. Journal of the American Society of Echocardiography. 22 (1): 1–23. doi:10.1016/j.echo.2008.11.029. ISSN 0894-7317.

[1]

[2]

Tricuspid stenosis classification

Overview

Classification

References

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