Fetal tricuspid regurgitation
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Tricuspid regurgitation (TR) (also known as tricuspid insufficiency) is a common finding in imaging of the fetus. Tricuspid regurgitation represents the abnormal backflow of blood into the right atrium during right ventricular contraction due to valvular leakage (i.e. it is a valvulopathy).
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Tricuspid regurgitation is a common sonographic finding during fetal life and can be seen in 7% of normal fetuses 1.
Trivial tricuspid regurgitation can be an isolated finding in an otherwise normal fetus with no other structural abnormality 2. It may be associated with aneuploidy and with both cardiac and extracardiac defects 3-5.
Technique: the pulsed Doppler gate (sample volume of 2-3 mm) should be placed perpendicular across the tricuspid valve in the four-chamber view with the angle of insonation <20°. It is recommended that the sweep speed is set at 200-300 mm/sec. A high sweep speed ensures greater details of the waveform.
Diagnosis is made when the regurgitation jet velocity is at least 80 cm/sec and its interval extends to more than half of systole 7.Color Doppler shows flow in the opposite direction with a different color compared to mitral valve flow with aliasing, denoting high-velocity flow in opposite direction.
Trivial tricuspid regurgitation
- prevalence: 1-5%
- isolated finding
- resolution with follow-up
Mild tricuspid regurgitation
- mid or early systolic
- peak velocity: 30-70 cm/s
- jet extends <1/3 distance to the opposite atrial wall 6
Severe tricuspid regurgitation
- peak velocity: 180-350 cm/s
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