Abstract:
Tricuspid regurgitation (TR) can have a significant impact on the health and mortality of a patient. Unfortunately, many patients with advanced right-sided heart failure are not referred for isolated tricuspid valve (TV) surgery in a timely manner. This delayed referral has resulted in a high in-hospital mortality rate and significant undertreatment. Fortunately, transcatheter TV intervention (TTVI) has emerged as a safe and effective alternative to surgery, successfully reducing TR severity and improving patients\' quality of life. Current guidelines emphasize the importance of assessing TR severity and its impact on the right heart chambers for selecting the appropriate intervention. However, the echocardiographic assessment of both right chambers and TV anatomy, along with TR severity, poses specific challenges, leading to the underestimation of TR severity. Recently, three-dimensional echocardiography has become crucial to enhance the characterization of TR severity. Moreover, it is essential to evaluate residual TR after TTVI to gauge the intervention\'s success and predict the patient\'s prognosis. This review provides a thorough evaluation of the echocardiographic parameters used to assess TR severity before and after TTVI. It presents a critical analysis of the accuracy and reliability of these parameters, highlighting their strengths and limitations to establish standardized diagnostic criteria and treatment protocols for TR, which will inform clinical decision-making and improve patient outcomes.
摘要:
三尖瓣反流(TR)可对患者的健康和死亡率具有显著影响。不幸的是,许多晚期右心衰竭患者未及时转诊进行孤立性三尖瓣(TV)手术.这种延迟转诊导致了很高的住院死亡率和严重的治疗不足。幸运的是,经导管电视介入(TTVI)已成为一种安全有效的手术替代方案,成功降低TR严重程度并改善患者的生活质量。当前的指南强调评估TR严重程度及其对右心室的影响以选择适当的干预措施的重要性。然而,右腔和电视解剖的超声心动图评估,连同TR严重性,提出了具体的挑战,导致对TR严重程度的低估。最近,三维超声心动图已成为增强TR严重程度表征的关键。此外,评估TTVI后的残余TR对于评估干预的成功和预测患者的预后至关重要。这篇综述全面评估了用于评估TTVI前后TR严重程度的超声心动图参数。它提出了这些参数的准确性和可靠性的关键分析,强调他们的优势和局限性,以建立标准化的TR诊断标准和治疗方案,这将为临床决策提供信息并改善患者预后。