A 41-year-old female with tricuspid valve replacement presented to the Houston Methodist Hospital with dyspnea. (A) Spectral Doppler by transthoracic echocardiogram (TTE) revealed high velocity with rounded contour. (B) Three-dimensional (3D) transesophageal (TEE) image of the prosthesis during diastole. (C) 64-multislice cardiac computed tomography demonstrated a degenerative prosthetic tricuspid valve with severely thickened and calcified leaflets. (D) Anatomic orifice area calculated by planimetry was found to be 1 cm2 (green perimeter trace). (E) Excised valve showing the extent of valve degeneration.
