Tricuspid Valve: Stenosis, Regurgitation and Both

The Tricuspid Valve is the largest valve of the Heart in terms of orifice size. The pathology involving the Tricuspid Valve is reflected not only in the Right Atrium and Right Ventricle but also the Superior and Inferior Vena Cava more so because both these do not have Valves. Moreover, the venous return to the Right Atrium can be impacted due to changes in the flow of blood through the Tricuspid Valve (Stenosis, Regurgitation or both). Also, changes in the venous return to the heart can affect the Tricuspid Valve (Example: Infective Endocarditis). Tricuspid Valve is unique in that, the events of the Left side of the Heart, may adversely affect its functioning (Example: Mitral Stenosis leading to Tricuspid Regurgitation) When this happens, the prognosis is usually poor due to considerable pressure changes in the Pulmonary Vascular Tree. Pathology involving the lungs (Cor Pulmonale) may affect the Tricuspid Valve adversely. Moreover, the Tricuspid valve leaflets are prone to injury when catheters (Swan Ganz), guidewires, Pacemaker wires, ICE probe etc. are passed through its orifice, resulting in Regurgitation. Some conditions like Carcinoid Syndrome and Ebstein’s Anomaly are unique to the Tricuspid Valve. All these topics are discussed in this chapter.