Guidelines
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] :
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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)
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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] :
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Symptomatic patients with severe tricuspid stenosis
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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)
Media Gallery
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Tricuspid Stenosis. A representation of a stenotic tricuspid valve. This image demonstrates fusion of the commissures (shown as dotted lines).
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