Tricuspid Valve

  • Michael Y. HeneinEmail author
  • Mary Sheppard
  • John R. Pepper
  • Michael Rigby


The morphologically right atrioventricular valve has three leaflets (tricuspid): septal, inferior (mural), and anterosuperior which are separated from each other by anteroseptal, superoinferior, and inferoseptal commissures, respectively. The inferior leaflet takes its origin exclusively from the diaphragmatic parietal wall of the ventricle and is often called the mural leaflet. Each commissure is usually supported by the corresponding papillary muscle. The most characteristic and distinguishing feature of the tricuspid valve is the direct attachment of the cords from the septal leaflet to the septum.


Atrial Septal Defect Tricuspid Valve Tricuspid Regurgitation Atrioventricular Valve Tricuspid Annulus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 3.1

Apical views showing dilated right heart

Video 1.avi (2,433 KB)

Video 3.2

Apical views showing tricuspid regurgitation on colour Doppler

Video 2.avi (1,224 KB)

76621_2_En_3_MOESM3_ESM.mpg (1.6 mb)
Video 3.3 Apical views from a patient with rheumatic mitral and tricuspid valve disease Video 3.avi (1,686 KB)
Video 3.4

Apical views from a patient with Ebstein anomaly

video 4-.avi (4,398 KB)

Video 3.5

Apical views showing mild tricuspid regurgitation on colour Doppler

video 5.avi (1,695 KB)

76621_2_En_3_MOESM6_ESM.mpg (1.2 mb)
Video 3.6 severe tricuspid regurgitation and PISA video6.avi (1,214 KB)


  1. 1.
    Daniels SJ, Mintz GS, Kotler MN. Rheumatic tricuspid valve disease: two-dimensional echocardiographic, hemodynamic, and angiographic correlations. Am J Cardiol. 1983;51(3):492–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Guyer DE, Gillam LD, Foale RA, Clark MC, Dinsmore R, Palacios I, et al. Comparison of the echocardiographic and hemodynamic diagnosis of rheumatic tricuspid stenosis. J Am Coll Cardiol. 1984;3(5):1135–44.PubMedCrossRefGoogle Scholar
  3. 3.
    Shimada R, Takeshita A, Nakamura M, Tokunaga K, Hirata T. Diagnosis of tricuspid stenosis by M-mode and two-dimensional echocardiography. Am J Cardiol. 1984;53(1):164–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Pellikka PA, Tajik AJ, Khandheria BK, Seward JB, Callahan JA, Pitot HC, et al. Carcinoid heart disease. Clinical and echocardiographic spectrum in 74 patients. Circulation. 1993;87(4):1188–96.PubMedGoogle Scholar
  5. 5.
    Ross EM, Roberts WC. The carcinoid syndrome: comparison of 21 necropsy subjects with carcinoid heart disease to 15 necropsy subjects without carcinoid heart disease. Am J Med. 1985;79(3):339–54.PubMedCrossRefGoogle Scholar
  6. 6.
    Heaven DJ, Henein MY, Sutton R. Pacemaker lead related tricuspid stenosis: a report of two cases. Heart. 2000;83(3):351–2.PubMedCrossRefGoogle Scholar
  7. 7.
    Denning GK, Henneke KH, Rudolph W (1987) Assessment of tricuspid stenosis by Doppler echocardiography. J Am Coll Cardiol. AbstractGoogle Scholar
  8. 8.
    Parris TM, Panidis JP, Ross J, Mintz GS. Doppler echocardiographic findings in rheumatic tricuspid stenosis. Am J Cardiol. 1987 Dec 1;60(16):1414–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Veyrat C, Kalmanson D, Farjon M, Manin JP, Abitbol G. Non-invasive diagnosis and assessment of tricuspid regurgitation and stenosis using one and two dimensional echo-pulsed Doppler. Br Heart J. 1982;47(6):596–605.PubMedCrossRefGoogle Scholar
  10. 10.
    Henein MY, Sheppard M, Ho Y, Pepper J, Gibson DG. Evidence for rheumatic valve disease in patients with severe tricuspid regurgitation long after mitral valve surgery – role of 3D reconstruction. J Heart Valve Dis. 2003;12(5):566–72.PubMedGoogle Scholar
  11. 11.
    Ginzton LE, Siegel RJ, Criley JM. Natural history of tricuspid valve endocarditis: a two dimensional echocardiographic study. Am J Cardiol. 1982;49(8):1853–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Bates ER, Sorkin RP. Echocardiographic diagnosis of flail anterior leaflet in tricuspid endocarditis. Am Heart J. 1983;106(1 Pt 1):161–3.PubMedCrossRefGoogle Scholar
  13. 13.
    Howard RJ, Drobac M, Rider WD, Keane TJ, Finlayson J, Silver MD, et al. Carcinoid heart disease: diagnosis by two-dimensional echocardiography. Circulation. 1982;66(5):1059–65.PubMedCrossRefGoogle Scholar
  14. 14.
    Chandraratna PN, Lopez JM, Fernandez JJ, Cohen LS. Echocardiographic detection of tricuspid valve prolapse. Circulation. 1975;51(5):823–6.PubMedGoogle Scholar
  15. 15.
    Rippe JM, Angoff G, Sloss LJ, Wynne J, Alpert JS. Multiple floppy valves: an echocardiographic syndrome. Am J Med. 1979;66(5):817–24.PubMedCrossRefGoogle Scholar
  16. 16.
    Schlamowitz RA, Gross S, Keating E, Pitt W, Mazur J. Tricuspid valve prolapse: a common occurrence in the click-murmur syndrome. J Clin Ultrasound. 1982;10(9):435–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Suzuki Y, Kambara H, Kadota K, Tamaki S, Yamazato A, Nohara R, et al. Detection and evaluation of tricuspid regurgitation using a real-time, two-dimensional, color-coded, Doppler flow imaging system: comparison with contrast two-dimensional echocardiography and right ventriculography. Am J Cardiol. 1986;57(10):811–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Currie PJ, Seward JB, Chan KL, Fyfe DA, Hagler DJ, Mair DD, et al. Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-catheterization study in 127 patients. J Am Coll Cardiol. 1985;6(4):750–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Sakai K, Nakamura K, Satomi G, Kondo M, Hirosawa K. Hepatic vein blood flow pattern measured by Doppler echocardiography as an evaluation of tricuspid valve insufficiency. J Cardiogr. 1983;13(1):33–43.PubMedGoogle Scholar
  20. 20.
    Chan KL, Currie PJ, Seward JB, Hagler DJ, Mair DD, Tajik AJ. Comparison of three Doppler ultrasound methods in the prediction of pulmonary artery pressure. J Am Coll Cardiol. 1987;9(3):549–54.PubMedCrossRefGoogle Scholar
  21. 21.
    Dreyfus GD, Souza Neto O, Aubert S. Papillary muscle repositioning for repair of anterior leaflet prolapse caused by chordal elongation. J Thorac Cardiovasc Surg. 2006;132(3):578–84.PubMedCrossRefGoogle Scholar
  22. 22.
    Dreyfus GD, Corbi PJ, Chan KM, Bahrami T. Secondary tricuspid regurgitation or dilatation: which should be the criteria for surgical repair? Ann Thorac Surg. 2005;79(1):127–32.PubMedCrossRefGoogle Scholar
  23. 23.
    Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G, et al. Guidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007;28(2):230–68. Epub Jan 26, 2007. No abstract available.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  • Michael Y. Henein
    • 1
    Email author
  • Mary Sheppard
    • 2
  • John R. Pepper
    • 2
  • Michael Rigby
    • 2
  1. 1.Department of Public Health and Clinical Medical and Heart CentreUmea UniversityUmeaSweden
  2. 2.Royal Brompton HospitalLondonUK

Personalised recommendations