Tricuspid stenosis classification

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

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 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.

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