Echocardiographic evaluation of the severity of tricuspid valve regurgitation: 29 considerations useful in recognizing hemodynamically important lesions.

Tricuspid regurgitation is a commonly encountered condition, but precise methods of measuring its severity await development. The purpose of this review is to propose 29 echocardiographic and Doppler considerations that can be applied to gain a qualitative impression of the "significance or severity" of this regurgitant lesion. These methods evaluate the right heart chambers, the morphology of the valve, regurgitant Doppler flow signals, and forward flow. The proposed methods are based on echocardiographic techniques for evaluating mitral regurgitation. However, the literature on directly applying these considerations to judging the severity of tricuspid regurgitation is scant and caution is urged in applying them. One intended consequence of this review is to identify understudied features of tricsupid regurgitation so that those engaged in echocardiographic clinical investigation may be stimulated to develop the tools needed for its ultimate quantitation.