5 Topic Commentaries

Tricuspid regurgitation thresholds reassessed

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  Rebecca T. Hahn, MD

  Cardiology (Echocardiography)

  •

  Columbia University Irving Medical Center

  Color Doppler is based on momentum, which is based on pressure. High pressure on the left side will have a certain area of color that will not ever be seen on the right side because it's lower pressure. So, if you wait for the same measures of the color area on the right side, then you're looking at very severe, end-stage TR.

  Source
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  Gorav Ailawadi, MD, MBA

  Cardiothoracic Surgery

  •

  University of Michigan

  If a patient gets an echo ordered from their primary doctor, without mention nor concern about the tricuspid valve, the sonographers often will take very few images of the tricuspid valve or the readers will miss the TR entirely.

  Source
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  Robert O. Bonow, MD

  Cardiology

  •

  Northwestern University Feinberg School of Medicine

  If your patient has developed liver enzyme abnormalities, you've waited too long.

  Source
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  Rajendra R. Makkar, MD

  Cardiology

  •

  University of California, Los Angeles

  With replacement, 95-97% of patients will have mild or less residual TR. With repair, almost 30% will have moderate or more residual regurgitation.

  Source
• 

  Susheel K. Kodali, MD

  Interventional Cardiology

  •

  Columbia University Irving Medical Center

  We'd like to see mortality benefit and we haven't seen one yet with either of the approved devices, but there are several factors that suggest the quality-of-life improvements we have seen are, one, related to the degree of TR reduction and, two, not a placebo effect.

  Source