Wang Dee Dee, Lee James C, O'Neill Brian P, O'Neill William W
Center for Structural Heart Disease, Henry Ford Hospital, 2799 West Grand Boulevard, Clara Ford Pavilion 4th Floor, 432, Detroit, MI 48202, USA.
Center for Structural Heart Disease, Henry Ford Hospital, 2799 West Grand Boulevard, Clara Ford Pavilion 4th Floor, 432, Detroit, MI 48202, USA.
Interv Cardiol Clin. 2018 Jul;7(3):379-386. doi: 10.1016/j.iccl.2018.04.001. Epub 2018 Jun 29.
The tricuspid valve is a highly complex structure, with variability in the number of leaflets and scallops. The mechanism of regurgitation is multifactorial in etiology, a mix of functional and degenerative tricuspid regurgitation. Iatrogenic tricuspid regurgitation is becoming more common secondary to pacemaker wire impingement of leaflet function and coaptation. Echocardiographic imaging of the tricuspid valve is particularly challenging given its anatomic location and other interfering structures, including pacemaker wires. Preprocedural planning and intraprocedural guidance for transcatheter intervention relies on a comprehensive understanding of tricuspid anatomy and the use of 3-dimensional transesophageal echocardiography. The incorporation of computed tomography and cardiac magnetic resonance imaging likely will provide increasing accuracy and optimization of procedural success.
三尖瓣是一个高度复杂的结构，其瓣叶和扇区数量存在变异性。反流机制在病因学上是多因素的，是功能性和退行性三尖瓣反流的混合。医源性三尖瓣反流由于起搏器导线对瓣叶功能和对合的影响而变得越来越常见。鉴于三尖瓣的解剖位置和包括起搏器导线在内的其他干扰结构，三尖瓣的超声心动图成像尤其具有挑战性。经导管介入治疗的术前规划和术中指导依赖于对三尖瓣解剖结构的全面了解以及三维经食管超声心动图的使用。计算机断层扫描和心脏磁共振成像的结合可能会提高准确性并优化手术成功率。
