Tricuspid Valve Regurgitation Calculator

Perform online calculations to determine the Class of Recommendation for Tricuspid Valve Regurgitation Intervention according to Guidelines

March 15th, 2022
(updated April 14th, 2022)

Echocardiographic Criteria to Define Severe TR

Qualitative
Tricuspid valve morphologyAbnormal/ flail
Colour flow regurgitant jetVery large central jet or eccentric wall impinging jet (using Niquist limit = 50-60 cm/s)
Continuous wave signal of regurgitant jetDense / triangular with early peaking
Semiquantitative
Vena contract width, preferably biplane (mm)> 7 (using Niquist limit = 50-60 cm/s)
PISA radius (mm)> 9 (using baseline Nyquist limit shift of 28 cm/s)
Hepatic vein flowSystolic flow reversal
Tricuspid inflowE-wave dominant => 1 m/s (in the absence of other causes of elevated RA pressure)
Quantitative
EROA (mm2)=> 40
Regurgitant volume (mL/beat)=> 45
Enlargement of cardiac chambers / vesselsright ventricle, right atrium, inferior vena cava

Legend

  • TR Grade
  • Symptoms
  • Mechanism (Primary / Secondary)
  • Secondary: with LH disease / Isolated
  • Need for left-sided valve surgery
  • Previous left-sided valve surgery
  • Experienced Center with HT
  • Eligible for surgery
  • RV dilatation
  • Severe RV dysfunction
  • Severe LV dysfunction
  • Severe annular dilatation
  • Extensive leaflet damage
  • Trace= 1 / Mild= 2 / Moderate= 3 / Severe= 4
  • No or mild= 0 / Yes= 1
  • Primary= 1 / Secondary= 2
  • LH disease=1 / Isolated= 2
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1

Abbreviations

  • BSA: Body Surface Area
  • EROA: Effective Regurgitant Orifice Area
  • PISA: Proximal Isovelocity Surface Area
  • LV: Left Ventricle
  • RV: Right Ventricle
  • TTVI: Transcatheter Tricuspid Valve Intervention
  • TV: Tricuspid Valve