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Study Examines If Tricuspid Valve Size in Tetralogy of Fallot Patients After Surgery Corresponds With Right Ventricular Volume and Need for Pulmonary Valve Replacement

April 5, 2022

A recent study from researchers at the Heart Institute at UPMC Children’s Hospital of Pittsburgh examined whether the size of the tricuspid valve as ascertained using transthoracic echocardiogram in patients with repaired Tetralogy of Fallot is associated with right ventricular volume and a clinical necessity for pulmonary valve replacement.

Contributing to the study was Adam B. Christopher, MD, director of cardiac MRI and CT at the Heart Institute. Pediatric cardiology fellow Katelyn Snyder, MD, was the study’s first author.

The study, “Tricuspid Valve Size Relationship to Right Ventricular Volume in Post-operative Tetralogy of Fallot Patients,” was published in January 2022 in the journal Pediatric Cardiology.

Important Findings

One of the aims of the study was to determine if echocardiographic measures of tricuspid valve size could be used as a simple yet effective proxy for right ventricular volume and right ventricular dilation.

While the study found that tricuspid valve size alone did not strongly correlate with the size of the right ventricle, and, therefore, could not be used in lieu of a cardiac MRI scan, several other important findings were noted that can aid clinical decision making.

The team discovered that a tricuspid valve z-score greater than 2 (more than 2 standard deviations above the mean) had a positive predictive value of 100%, indicating a right ventricular end-diastolic volume indexed to body surface area of > 150 ml/m2, a common threshold for pulmonary valve replacement. This finding on echocardiogram can then be confirmed on MRI before proceeding with a recommendation for valve replacement. 

Read more about the study and its other findings using the reference and link below.

Study Reference

Snyder K, Drant S, Carris E, Christopher A, Allada V. Tricuspid Valve Size Relationship to Right Ventricular Volume in Post-operative Tetralogy of Fallot Patients. Pediatr Cardiol. 2022 Jan 4. Online ahead of print.