Tricuspid Stenosis Guidelines

Updated: Sep 21, 2021
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Guidelines Summary

In 2014, the AHA/ACC released a revision to its 2008 guidelines for management of patients with valvular heart disease (VHD); and ESC/EACTS issued a revision of its 2007 guidelines in 2021. [13, 14]

The AHA/ACC guidelines include the following recommendations for diagnostic testing and initial diagnosis of tricuspid stenosis (TS) [13] :

  • Transthoracic echocardiography (TTE) is indicated to assess the anatomy of the valve complex, evaluate severity of stenosis, and characterize any associated regurgitation and/or left-sided valve disease. (Class I; Level of Evidence: C)
  • Conaider invasive hemodynamic assessment of severity of TS in symptomatic patients when clinical and noninvasive data are discordant.(Class IIb; Level of Evidence: C)

Both guidelines concur that Class I indications for tricuspid valve surgery are as follows [13, 14] :

  • Symptomatic patients with severe tricuspid stenosis
  • Patients with severe tricuspid stenosis undergoing left-sided valve intervention

The AHA/ACC guidelines also recommend consideration of percutaneous balloon tricuspid commissurotomy in patients with isolated, symptomatic severe TS without accompanying TR. (Class IIb; Level of Evidence: C)