Tricuspid valve disorders can be routinely identified and their severity estimated by echocardiography. From a technical standpoint, transthoracic echocardiography (TTE) of the tricuspid valve is slightly more challenging than it is for left-sided valves. The location of the tricuspid valve as the most rightward valve places it at or just beneath the sternal edge and requires the ultrasound beam to be angled sharply rightward while maintaining transducer contact with the chest wall. Image quality from the apical and subcostal windows is limited by far field beam attenuation and dispersion.
Despite these impediments, the tricuspid valve can be adequately evaluated in most TTE examinations.
ECHOCARDIOGRAPHY OF THE NORMAL TRICUSPID VALVE
Anatomically, the tricuspid valve consists of anterior, septal and posterior leaflets. The anterior leaflet is the most anatomically constant echocardiographic feature, with the septal and posterior leaflets being variable in size and position.
Transthoracic echocardiogram — On two dimensional (2-D) TTE, the tricuspid valve is routinely recorded from the long (image 1) and short axis parasternal, apical four chamber, and subcostal views. The normal tricuspid valve thickness is <3 mm .
Identification of individual tricuspid leaflets in the 2-D views has been controversial. Data from pathologic examination, rotational 2-D tomograms, and 2-D reconstructions from three-dimensional (3-D) images have facilitated correct leaflet identification in 2-D views [2-4]: