Tricuspid regurgitation echocardiography: Difference between revisions

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{{Tricuspid regurgitation}}
{{Tricuspid regurgitation}}
{{CMG}} {{AE}} {{Rim}} {{FB}}
{{CMG}} ; {{AE}} {{VKG}} {{Rim}} {{FB}}


==Overview==
==Overview==
[[Transthoracic echocardiography]] ([[TTE]]) is usually adequate for the evaluation of tricuspid regurgitation; to confirm the diagnosis, determine the etiology, establish the baseline severity and for the assessment of the function of the [[right ventricle]] prior to surgery. In cases of non-diagnostic transthoracic studies, [[transesophageal echocardiography]] (TEE) improves the visualization of the valvular structure and delineates the mechanism and severity of regurgitation.<ref name="pmidPMID: 12835667">{{cite journal| author=Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA et al.| title=Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. | journal=J Am Soc Echocardiogr | year= 2003 | volume= 16 | issue= 7 | pages= 777-802 | pmid=PMID: 12835667 | doi=10.1016/S0894-7317(03)00335-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12835667  }} </ref>
[[Transthoracic echocardiography]] ([[TTE]]) is usually adequate for the evaluation of [[tricuspid regurgitation]]; to confirm the [[diagnosis]], determine the etiology, establish the baseline severity and for the assessment of the function of the [[right ventricle]] prior to [[surgery]]. In cases of non-diagnostic [[Transthoracic echocardiography|transthoracic]] studies, [[transesophageal echocardiography]] ([[Transesophageal echocardiography (TEE)|TEE]]) improves the visualization of the [[valvular]] structure and delineates the mechanism and severity of [[regurgitation]].


==Echocardiography==
==Echocardiography==
Echocardiography with Doppler is the method of choice for the non-invasive detection and evaluation of the severity and etiology of valvular regurgitation. Echocardiography allows the evaluation of the following:<ref name="pmid24589852">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=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. | journal=Circulation | year= 2014 | volume= 129 | issue= 23 | pages= 2440-92 | pmid=24589852 | doi=10.1161/CIR.0000000000000029 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24589852  }} </ref>
[[Echocardiography]] with [[doppler]] is the method of choice for the [[Non-invasive (medical)|non-invasive]] detection and evaluation of the severity and [[etiology]] of valvular [[regurgitation]]. <ref name="pmid26503944">{{cite journal| author=Tornos Mas P, Rodríguez-Palomares JF, Antunes MJ| title=Secondary tricuspid valve regurgitation: a forgotten entity. | journal=Heart | year= 2015 | volume= 101 | issue= 22 | pages= 1840-8 | pmid=26503944 | doi=10.1136/heartjnl-2014-307252 | pmc=4680164 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26503944  }}</ref><ref name="pmidPMID: 12835667">{{cite journal| author=Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA et al.| title=Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. | journal=J Am Soc Echocardiogr | year= 2003 | volume= 16 | issue= 7 | pages= 777-802 | pmid=PMID: 12835667 | doi=10.1016/S0894-7317(03)00335-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12835667  }} </ref>[[Echocardiography]] allows the evaluation of the following:<ref name="pmid24589852">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=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. | journal=Circulation | year= 2014 | volume= 129 | issue= 23 | pages= 2440-92 | pmid=24589852 | doi=10.1161/CIR.0000000000000029 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24589852  }} </ref><ref name="pmid23993694">{{cite journal| author=Chen TE, Kwon SH, Enriquez-Sarano M, Wong BF, Mankad SV| title=Three-dimensional color Doppler echocardiographic quantification of tricuspid regurgitation orifice area: comparison with conventional two-dimensional measures. | journal=J Am Soc Echocardiogr | year= 2013 | volume= 26 | issue= 10 | pages= 1143-1152 | pmid=23993694 | doi=10.1016/j.echo.2013.07.020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23993694  }}</ref><ref name="pmid23860094">{{cite journal| author=de Agustin JA, Viliani D, Vieira C, Islas F, Marcos-Alberca P, Gomez de Diego JJ | display-authors=etal| title=Proximal isovelocity surface area by single-beat three-dimensional color Doppler echocardiography applied for tricuspid regurgitation quantification. | journal=J Am Soc Echocardiogr | year= 2013 | volume= 26 | issue= 9 | pages= 1063-72 | pmid=23860094 | doi=10.1016/j.echo.2013.06.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23860094  }}</ref><ref name="ZoghbiAdams2017">{{cite journal|last1=Zoghbi|first1=William A.|last2=Adams|first2=David|last3=Bonow|first3=Robert O.|last4=Enriquez-Sarano|first4=Maurice|last5=Foster|first5=Elyse|last6=Grayburn|first6=Paul A.|last7=Hahn|first7=Rebecca T.|last8=Han|first8=Yuchi|last9=Hung|first9=Judy|last10=Lang|first10=Roberto M.|last11=Little|first11=Stephen H.|last12=Shah|first12=Dipan J.|last13=Shernan|first13=Stanton|last14=Thavendiranathan|first14=Paaladinesh|last15=Thomas|first15=James D.|last16=Weissman|first16=Neil J.|title=Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation|journal=Journal of the American Society of Echocardiography|volume=30|issue=4|year=2017|pages=303–371|issn=08947317|doi=10.1016/j.echo.2017.01.007}}</ref><ref name="HahnThomas2019">{{cite journal|last1=Hahn|first1=Rebecca T.|last2=Thomas|first2=James D.|last3=Khalique|first3=Omar K.|last4=Cavalcante|first4=João L.|last5=Praz|first5=Fabien|last6=Zoghbi|first6=William A.|title=Imaging Assessment of Tricuspid Regurgitation Severity|journal=JACC: Cardiovascular Imaging|volume=12|issue=3|year=2019|pages=469–490|issn=1936878X|doi=10.1016/j.jcmg.2018.07.033}}</ref><ref name="pmid26758273">{{cite journal| author=Hudzik B, Poloński L, Gąsior M| title=Lancisi sign: giant C-V waves of tricuspid regurgitation. | journal=Intern Emerg Med | year= 2016 | volume= 11 | issue= 8 | pages= 1139-1140 | pmid=26758273 | doi=10.1007/s11739-015-1384-4 | pmc=5114320 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26758273  }}</ref>
 
* [[Right ventricle]] structure and function
* [[Right ventricle]] structure and function
* [[Right atrium]] structure and function
* [[Right atrium]] structure and function
* [[Inferior vena cava]]
* [[Inferior vena cava]]
* The structure and function of the left chambers of the heart
* The structure and function of the left chambers of the heart
* The structures of the [[tricuspid valve]] and the underlying etiology of mitral regurgitation
* The structures of the [[tricuspid valve]] and the underlying etiology of [[mitral regurgitation]]
* [[Pulmonary artery]] pressure
* [[Pulmonary artery]] pressure
* Pressures in the heart chambers
* Pressures in the [[heart]] chambers
* The severity of the tricuspid regurgitation through the measurement of:
* The severity of the [[tricuspid regurgitation]] through the measurement of:
** The tricuspid annular diameter in the apical 4-chamber view
** The tricuspid annular diameter in the apical 4-chamber view
** Tricuspid valve leaflet tethering height
**[[Tricuspid]] valve leaflet tethering height
** Tricuspid valve leaflet tethering area
**[[Tricuspid valve]] leaflet tethering area
** Tricuspid regurgitation jet velocity signal
**[[Tricuspid regurgitation]] jet velocity signal
*Characteristic primary [[Valvular Diseases|valvular]] abnormalities can be detected by [[tricuspid valve]] motion which includes the conditions like:
*Characteristic primary [[Valvular Diseases|valvular]] abnormalities can be detected by [[tricuspid valve]] motion which includes the conditions like:<ref name="Adler2017">{{cite journal|last1=Adler|first1=Dale S.|title=Non-functional tricuspid valve disease|journal=Annals of Cardiothoracic Surgery|volume=6|issue=3|year=2017|pages=204–213|issn=2225319X|doi=10.21037/acs.2017.04.04}}</ref><ref name="ParanonAcar2008">{{cite journal|last1=Paranon|first1=S.|last2=Acar|first2=P.|title=Ebstein's anomaly of the tricuspid valve: from fetus to adult|journal=Heart|volume=94|issue=2|year=2008|pages=237–243|issn=1355-6037|doi=10.1136/hrt.2006.105262}}</ref>
**[[Ebstein's anomaly]]
**[[Ebstein's anomaly]]
** [[Carcinoid Disease|Carcinoid]] heart disease
**[[Carcinoid Disease|Carcinoid]] heart disease
** [[Rheumatic Heart Disease|Rheumatic]] valve disease
**[[Rheumatic Heart Disease|Rheumatic]] [[valve disease]]
** [[Tricuspid valve prolapse]]
**[[Tricuspid valve prolapse]]
** Flail leaflet
** Flail leaflet
** [[Endocarditis]]
**[[Endocarditis]]
*By using the [[vena contracta]] method with colour doppler we can estimate the severity of the [[tricuspid regurgitation]] and that includes:
*By using the [[vena contracta]] method with colour doppler we can estimate the severity of the [[tricuspid regurgitation]] and that includes:
** The [[vena contracta]] width has to be more than 0.7 cm along with systolic flow reversal in the hepatic veins
** The [[vena contracta]] width has to be more than 0.7 cm along with systolic flow reversal in the [[hepatic]] veins
** In the presence of atrial fibrillation, systolic flow reversal in the hepatic veins cannot be accurate
** In the presence of [[atrial fibrillation]], systolic flow reversal in the [[hepatic]] veins cannot be accurate


* By using the modified Bernoulli equation, we can estimate the pulmonary hypertension on echocardiography by measuring the right ventricle to right atrial systolic gradient from the velocity of the tricuspid regurgitation jet<br>
* By using the modified [[Bernoulli equation]], we can estimate [[pulmonary hypertension]] on [[echocardiography]] by measuring the [[right ventricle]] to right atrial systolic gradient from the velocity of the [[tricuspid regurgitation]] jet
 
[[File:Three-dimensional echocardiography.jpg|center|thumb|600x600px|'''Comprehensive assessment of the anatomy of functional tricuspid regurgitation by transthoracic three-dimensional echocardiography. Two-dimensional color Doppler showing severe functional tricuspid regurgitation (A). ''En faces'' view of the tricuspid valve leaflets and annulus from the right atrial perspective (B). ''En faces'' view of the tricuspid valve leaflets from the right ventricular perspective (C). Semi-automated quantitative analysis of tricuspid annulus size and shape, showing the relationship with the 4-chamber view plane (green line along the septal-lateral direction; D). Lateral view showing the flattening of tricuspid annulus (E). Surface rendering and quantitative analysis of tricuspid annulus and leaflets (F). A: anterior tricuspid leaflet, Ao: aorta, IVC: inferior vena cava, MV: a mitral valve, P: posterior tricuspid leaflet, RVOT: right ventricular outflow tract, S: septal tricuspid leaflet.''' Case courtesy by Denisa Muraru<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4965422/|title=Revisit of Functional Tricuspid Regurgitation; Current Trends in the Diagnosis and Management|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]]
<br />[[File:Severe tricuspid regurgitation E00572 (CardioNetworks ECHOpedia).jpg|center|thumb|660x660px|https://commons.wikimedia.org/wiki/File:Severe_tricuspid_regurgitation_E00572_(CardioNetworks_ECHOpedia).jpg#/media/File:Severe_tricuspid_regurgitation_E00572_(CardioNetworks_ECHOpedia).jpg]]
<br>


===== Video demonstrating Tricuspid regurgitation on an echocardiogram =====
===== Video demonstrating Tricuspid regurgitation on an echocardiogram =====
{{#ev:youtube|UHNKYKyorJo}}
{{#ev:youtube|UHNKYKyorJo}}
== 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<ref name="pmid33332150">{{cite journal| author=Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F | display-authors=etal| title=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. | journal=Circulation | year= 2021 | volume= 143 | issue= 5 | pages= e72-e227 | pmid=33332150 | doi=10.1161/CIR.0000000000000923 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33332150  }}</ref> ==
=== Recommendations for Diagnosis of TR ===
{| class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="lightgreen" |1.   In patients with TR, TTE is indicated to evaluate the presence and severity of TR, determine the etiology, measure the sizes of the right-sided chambers and inferior vena cava, assess RV systolic function, estimate pulmonary artery systolic pressure, and characterize any associated left-sided heart disease. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of Evidence: C-LD'']])<nowiki>"</nowiki>
|}


==2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary<ref name="pmid24589852">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=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. | journal=Circulation | year= 2014 | volume= 129 | issue= 23 | pages= 2440-92 | pmid=24589852 | doi=10.1161/CIR.0000000000000029 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24589852  }} </ref>==
==2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary<ref name="pmid24589852">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=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. | journal=Circulation | year= 2014 | volume= 129 | issue= 23 | pages= 2440-92 | pmid=24589852 | doi=10.1161/CIR.0000000000000029 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24589852  }} </ref>==

Latest revision as of 14:34, 8 December 2022

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

Overview

Transthoracic echocardiography (TTE) is usually adequate for the evaluation of tricuspid regurgitation; to confirm the diagnosis, determine the etiology, establish the baseline severity and for the assessment of the function of the right ventricle prior to surgery. In cases of non-diagnostic transthoracic studies, transesophageal echocardiography (TEE) improves the visualization of the valvular structure and delineates the mechanism and severity of regurgitation.

Echocardiography

Echocardiography with doppler is the method of choice for the non-invasive detection and evaluation of the severity and etiology of valvular regurgitation. [1][2]Echocardiography allows the evaluation of the following:[3][4][5][6][7][8]

Comprehensive assessment of the anatomy of functional tricuspid regurgitation by transthoracic three-dimensional echocardiography. Two-dimensional color Doppler showing severe functional tricuspid regurgitation (A). En faces view of the tricuspid valve leaflets and annulus from the right atrial perspective (B). En faces view of the tricuspid valve leaflets from the right ventricular perspective (C). Semi-automated quantitative analysis of tricuspid annulus size and shape, showing the relationship with the 4-chamber view plane (green line along the septal-lateral direction; D). Lateral view showing the flattening of tricuspid annulus (E). Surface rendering and quantitative analysis of tricuspid annulus and leaflets (F). A: anterior tricuspid leaflet, Ao: aorta, IVC: inferior vena cava, MV: a mitral valve, P: posterior tricuspid leaflet, RVOT: right ventricular outflow tract, S: septal tricuspid leaflet. Case courtesy by Denisa Muraru[11]


https://commons.wikimedia.org/wiki/File:Severe_tricuspid_regurgitation_E00572_(CardioNetworks_ECHOpedia).jpg#/media/File:Severe_tricuspid_regurgitation_E00572_(CardioNetworks_ECHOpedia).jpg


Video demonstrating Tricuspid regurgitation on an echocardiogram

{{#ev:youtube|UHNKYKyorJo}}

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[12]

Recommendations for Diagnosis of TR

Class I
1.   In patients with TR, TTE is indicated to evaluate the presence and severity of TR, determine the etiology, measure the sizes of the right-sided chambers and inferior vena cava, assess RV systolic function, estimate pulmonary artery systolic pressure, and characterize any associated left-sided heart disease. (Level of Evidence: C-LD)"


2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary[3]

Class I
"1. TTE is indicated to evaluate severity of TR, determine etiology, measure sizes of right-sided chambers and inferior vena cava, assess RV systolic function, estimate pulmonary artery systolic pressure, and characterize any associated left-sided heart disease. (Level of Evidence: C)"
Class IIb
"1. CMR or real-time 3-dimensional echocardiography may be considered for assessment of RV systolic function and systolic and diastolic volumes in patients with severe TR (stages C and D) and suboptimal 2-dimensional echocardiograms. (Level of Evidence: C)"

==2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease - Evaluation of Tricuspid Valve Disease in Adolescents and Young Adults(DO NOT EDIT)[13]


Class I
"1. Doppler echocardiography is indicated for the initial evaluation of adolescent and young adult patients with TR, and serially every 1 to 3 years, depending on severity. (Level C)"

Sources

  • 2008 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [13]

References

  1. ↑ Tornos Mas P, Rodríguez-Palomares JF, Antunes MJ (2015). "Secondary tricuspid valve regurgitation: a forgotten entity". Heart. 101 (22): 1840–8. doi:10.1136/heartjnl-2014-307252. PMC 4680164. PMID 26503944.
  2. ↑ Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA; et al. (2003). "Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography". J Am Soc Echocardiogr. 16 (7): 777–802. doi:10.1016/S0894-7317(03)00335-3. PMID 12835667 PMID: 12835667 Check |pmid= value (help).
  3. ↑ 3.0 3.1 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. 129 (23): 2440–92. doi:10.1161/CIR.0000000000000029. PMID 24589852.
  4. ↑ Chen TE, Kwon SH, Enriquez-Sarano M, Wong BF, Mankad SV (2013). "Three-dimensional color Doppler echocardiographic quantification of tricuspid regurgitation orifice area: comparison with conventional two-dimensional measures". J Am Soc Echocardiogr. 26 (10): 1143–1152. doi:10.1016/j.echo.2013.07.020. PMID 23993694.
  5. ↑ de Agustin JA, Viliani D, Vieira C, Islas F, Marcos-Alberca P, Gomez de Diego JJ; et al. (2013). "Proximal isovelocity surface area by single-beat three-dimensional color Doppler echocardiography applied for tricuspid regurgitation quantification". J Am Soc Echocardiogr. 26 (9): 1063–72. doi:10.1016/j.echo.2013.06.006. PMID 23860094.
  6. ↑ Zoghbi, William A.; Adams, David; Bonow, Robert O.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A.; Hahn, Rebecca T.; Han, Yuchi; Hung, Judy; Lang, Roberto M.; Little, Stephen H.; Shah, Dipan J.; Shernan, Stanton; Thavendiranathan, Paaladinesh; Thomas, James D.; Weissman, Neil J. (2017). "Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation". Journal of the American Society of Echocardiography. 30 (4): 303–371. doi:10.1016/j.echo.2017.01.007. ISSN 0894-7317.
  7. ↑ Hahn, Rebecca T.; Thomas, James D.; Khalique, Omar K.; Cavalcante, João L.; Praz, Fabien; Zoghbi, William A. (2019). "Imaging Assessment of Tricuspid Regurgitation Severity". JACC: Cardiovascular Imaging. 12 (3): 469–490. doi:10.1016/j.jcmg.2018.07.033. ISSN 1936-878X.
  8. ↑ Hudzik B, Poloński L, Gąsior M (2016). "Lancisi sign: giant C-V waves of tricuspid regurgitation". Intern Emerg Med. 11 (8): 1139–1140. doi:10.1007/s11739-015-1384-4. PMC 5114320. PMID 26758273.
  9. ↑ Adler, Dale S. (2017). "Non-functional tricuspid valve disease". Annals of Cardiothoracic Surgery. 6 (3): 204–213. doi:10.21037/acs.2017.04.04. ISSN 2225-319X.
  10. ↑ Paranon, S.; Acar, P. (2008). "Ebstein's anomaly of the tricuspid valve: from fetus to adult". Heart. 94 (2): 237–243. doi:10.1136/hrt.2006.105262. ISSN 1355-6037.
  11. ↑ "Revisit of Functional Tricuspid Regurgitation; Current Trends in the Diagnosis and Management".
  12. ↑ 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).
  13. ↑ 13.0 13.1 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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