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Leaflet-to-Annulus Index (LAI) in a Patient with Tricuspid Regurgitation

Description

Tanaka et al used the leaflet-to-annulus index (LAI) to evaluate a patient with residual tricuspid regurgitation after transcatheter edge-to-edge repair. The authors are from Universitatsklinikum Bonn in Germany.


Patient selection: status post tricuspid transcatheter edge-to-edge repair

 

Measurement: biplane midesophageal four-chamber view (orthogonal to the anteroseptal coaptation line)

 

Parameters:

(1) length of the anterior leaflet in mm

(2) length of the septal leaflet in mm

(3) septolateral diameter of the tricuspid annulus in mm

(4) coaptation gap width, in mm

(5) tricuspid regurgitation jet location

 

index =

= (anterior leaflet length) + (septal leaflet length)) / (septolateral diameter)

 

where:

• An leaflet-to-annulus index >= 1.06 is high.

• An index < 1.06 is low.

 

Coaptation Gap

Regurgitation Jet

Leaflet to Annulus Index

Percentage wtih Residual TR 3+ or greater

< 7 mm

central or anteroseptal

< 1.06

23%

< 7 mm

central or anteroseptal

>= 1.06

15%

>= 7 mm

NA

< 1.06

60%

NA

not central or anteroseptal

< 1.06

60%

>= 7 mm

NA

< 1.06

25%

NA

not central or anteroseptal

< 1.06

25%

 


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