trikuspidal

Trikuspidal refers to the tricuspid valve, one of the four valves of the heart. The term derives from the Latin tri- meaning three and cuspis meaning cusp. The tricuspid valve separates the right atrium from the right ventricle and normally consists of three leaflets: anterior, posterior, and septal. These leaflets are attached to the papillary muscles via chordae tendineae, and the valve annulus changes size with the cardiac cycle and respiration.

The primary function of the tricuspid valve is to permit blood flow from the right atrium to the right ventricle during diastole and to prevent backflow into the atrium during ventricular systole. Proper coaptation of the leaflets ensures one-way flow; dysfunction can lead to regurgitation (tricuspid regurgitation) or, less commonly, stenosis.

Trikuspidal disease is most commonly due to functional or secondary tricuspid regurgitation, in which the valve is structurally normal but fails to close properly because of right ventricular dilation or elevated pressures from left-sided heart disease, pulmonary hypertension, or other cardiac conditions. Primary (organic) tricuspid regurgitation results from intrinsic valve pathology such as rheumatic disease, infective endocarditis, connective tissue disorders, carcinoid syndrome, or Ebstein anomaly. Tricuspid stenosis is rare.

Diagnosis relies on imaging, with echocardiography as the primary modality to assess valve morphology and function. Additional assessments may include transesophageal echo, cardiac MRI, and ECG. Treatment ranges from watchful waiting and medical management (diuretics for congestion) to surgical repair or replacement of the tricuspid valve. Annuloplasty to reduce the annulus size is common, and in some cases valve replacement with a prosthetic device or transcatheter approaches for high-risk patients are used. Prognosis depends on the underlying cause and the presence of right-sided heart failure.