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Figure 9. Color Doppler parasternal short axis, tricuspid regurgitation and Gerbode defect
Figure 10. Color Doppler parasternal short axis, tricuspid regurgitation and Gerbode defect
Figure 10. Color Doppler parasternal short axis, tricuspid regurgitation and Gerbode defect

Careful angulation of the probe in color Doppler modality (in the short axis view of the tricuspid annulus and aortic root, Figure 9) shows the origin of the 2 jets (Figure 10): the first originating from the tricuspid valve (central position; white solid arrow); the second originating from the aortic root (white dashed arrow). The 2 jets after the origins tend to fuse inside the right atrial cavity.
Thus, the tricuspid regurgitation lower velocity jet points at a normal right ventricular- atrial pressure difference and normal estimated pulmonary systolic pressure, whereas the high velocity jets points at the higher aorto-atrial pressure difference (130 mmHg).

Figure 11. Color Doppler parasternal long axis, tricuspid annulus
Figure 12. Color Doppler parasternal long axis, tricuspid annulus
Figure 12. Color Doppler parasternal long axis, tricuspid annulus

The 2 separate jets could also be visualized in the parasternal long-axis view of right ventricular inflow (Figures 11-12). White solid arrow: tricuspid regurgitation; white dashed arrow: Gerbode acquired defect.

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