Key result
Noninvasive imaging reveals extreme tricuspid leaflet variability and an absent right AV junction fibrous ring.
Why the study?
Although the tricuspid valve is no longer forgotten, its anatomy remains poorly understood with several controversial and unclear aspects.
This review clarifies the complex and highly variable anatomy of the tricuspid valve using multimodality imaging, proposing a novel terminology for its leaflets.
May influence tricuspid intervention planning; leaves open validation of novel leaflet terminology.
Even though the tricuspid valve is no longer "forgotten", it still remains poorly understood. In this review, we focus on some controversial and still unclear aspects of tricuspid anatomy as illustrated by noninvasive imaging techniques. In particular, we discuss the anatomical architecture of the so-called tricuspid annulus with its two components (i.e., the mural and the septal annulus), emphasizing the absence of any fibrous "ring" around the right atrioventricular junction. Then we discussed the extreme variability in number and size of leaflets (from two to six), highlighting the peculiarities of the septal leaflet as part of the septal atrioventricular junction (crux cordis). Finally, we describe the similarities and differences between the tricuspid and mitral valve, suggesting a novel terminology for tricuspid leaflets.
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Schlossbauer et al. (2021) conducted a review in Tricuspid valve anatomy. Multimodality imaging was evaluated. Noninvasive multimodality imaging reveals the extreme variability of tricuspid valve leaflets (from two to six) and the absence of a fibrous ring around the right atrioventricular junction.
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