Tricuspid valve disease: Tricuspid valve complex perspective

The TVC forms the interface between the vast venous circulation and the right heart, and it is a window on the pulmonary circulation with views that extend to the rest of the circulation. The clinical approach to TV disease requires awareness of the many facets the anatomy and function of TVC. The classification of TV disease involves a broad spectrum of etiologic, morphologic, and mechanistic factors that contribute to the pathophysiologic responses to disordered TVC function. Although the phenomena that accompany TVC dysfunction occur within the boundaries of the right heart, the consequences eventually become systemic. The clinical diagnosis of TV disease begins with the individual patient, with the clinician's use of classic physical diagnostic principles, and extends to contemporary technologic interrogation involving imaging and hemodynamic data. Diagnostic precision in patients with TV disease precedes rational therapy. Evolving technology offers the ability to measure phenomena not previously quantified such as atrial structure and function yielding important new insights into consequences of TV disease. The template for charting management and therapy for patients with TV disease ultimately involves the individual patient analysis and should result in a high degree of clinical coherence.