Transthoracic Doppler echocardiography of normal tricuspid valve prostheses: comparison between surgical and transcatheter approaches
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Tricuspid valve (TV) replacement with surgical bioprosthetic, surgical mechanical, or transcatheter prostheses is a critical intervention for severe tricuspid regurgitation or stenosis. However, comprehensive echocardiographic comparisons of hemodynamic performance across these prosthesis types remain limited, especially for novel transcatheter prostheses. This study aimed to systematically analyze the transthoracic echocardiographic (TTE) Doppler parameters of three types of tricuspid prostheses with normal function to provide accurate references for the management of patients following clinical TV replacement (TVR). Methods: This retrospective study included 62 patients with surgical bioprosthetic valves, 52 with surgical mechanical valves, and 25 with transcatheter valves. Clinical data, along with comprehensive two-dimensional (2D) and Doppler echocardiographic parameters, were collected from normal tricuspid prostheses. Doppler parameters were measured at the TV position, including peak early tricuspid diastolic velocity (E velocity), mean gradient (MGTV), velocity-time integral (VTITV), pressure half-time (PHTTV), the ratio of VTITV to the VTI of the left ventricular outflow tract (VTI ratio), the effective orifice area (EOATV), and the indexed effective orifice area (IEOATV). Results: The normal ranges (95% confidence interval) of transthoracic Doppler echocardiographic parameters for the three types of tricuspid prostheses were established for surgical bioprosthetic valves (E velocity, 1.40–1.59 m/s; MGTV, 3.90–4.93 mmHg; VTITV, 41.8–47.2 cm; PHTTV, 135.8–157.8 ms; VTI ratio, 2.03–2.31; EOATV, 1.44–1.69 cm2; IEOATV, 0.92–1.09 cm2/m2), surgical mechanical valves (E velocity, 1.40–1.58 m/s; MGTV, 3.08–3.93 mmHg; VTITV, 34.6–39.9 cm; PHTTV, 106.7–122.8 ms; VTI ratio, 1.70–2.04; EOATV, 1.73–2.10 cm2; IEOATV, 1.08–1.31 cm2/m2), and transcatheter valves (E velocity, 1.21–1.51 m/s; MGTV, 2.58–4.83 mmHg; VTITV, 32.7–40.4 cm; PHTTV, 107.5–132.2 ms; VTI ratio, 1.60–1.99; EOATV, 1.80–2.44 cm2; IEOATV, 1.15–1.54 cm2/m2). Conclusions: This study established prosthesis-specific echocardiographic reference values for normal tricuspid prostheses. Values outside these ranges may indicate dysfunction, although the clinical correlation remains to be determined. These findings can enhance the postoperative monitoring of tricuspid prostheses.
Authors: Jia Xu, Xin Zhang, Yu Fu, Lingyun Fang, Jing Wang, Tang Gao, Yuman Li, Jie Liu, Haiyan Cao, Li Zhang, Mingxing Xie, Qing Lv, Wenqian Wu
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7117674940
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