Table 11.
Echocardiographic Parameters for Assessing TR Severity Pre- and Post-TTVR
| Baseline | Post-TEER | Post-Annular Repair | Post-TTVR (Orthotopic) | |
|---|---|---|---|---|
| Qualitative parameters | ||||
| Flow convergence zone | + | + | + | + |
| CWD jet density/shape | + | + | + | + |
| Semiquantitative parameters | ||||
| Color flow jet area | ++ | + | + | + |
| VC width (average of orthogonal views) | +++ | + (adding multiple jets has not been validated) | +++ | +++ |
| PISA radius | +++ | ± (abnormal shape of proximal flow may result in overestimation) | +++ | +++ (for central TR) |
| Hepatic vein flow pattern | ++ | ± (abnormal RA compliance may affect specificity) | ± (abnormal RA compliance may affect specificity) | ± (abnormal RA compliance may affect specificity) |
| Quantitative parameters | ||||
| PISA EROA | +++ | ± (abnormal shape of proximal flow may result in overestimation) | + | +++ (for central TR) |
| 2D Doppler quantitative EROA | ++ | - | + | - |
| 3D vena contracta area | +++ | +++ | +++ | +++ |
| Regurgitant volume | +++ | + | + | + |
| Regurgitant fraction | +++ | (+)a | +++ | (+)a |
PISA = proximal isovelocity surface area; VC = vena contracta; other abbreviations as in Tables 3 and 4.
aGiven the diastolic flow restriction by the device, diastolic stroke volume will be overestimated. Regurgitant fraction may be performed if a total RV stroke volume is obtained by other methods (ie, 3D echocardiography or cardiac magnetic resonance) and regurgitant volume is quantified by 3D VCA. + indicates the utility of the parameter with multiple plus signs indicating greater utility; − indicates no utility or significant limitations of the parameter; ± indicates possible utility.