Kebed et al reported criteria for massive tricuspid regurgitation, a subset of severe regurgitation with a poor prognosis. The authors are from the University of Chicago.
Patient selection: severe tricuspid regurgitation
Parameters:
(1) diameter of the vena contracta in mm
If the vena contracta is > 9.2 mm, the patient had massive tricuspid regurgitation.
This was a subset of the torrential grade of Fortuni et al, defined as >= 7.0 mm.
Implications of massive regurgitation:
(1) adverse right ventricular remodeling, with right ventricular dilatation
(2) reduced survival (15-30% 5-year survival if massive vs 40-44% if nonmassive)
(3) larger tricuspid annular diameter
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