Anatomical evaluation of a novel echocardiography based tricuspid valve classification in 60 hearts from body donors.

This study aimed at providing comprehensive morphological descriptions of the morphology of the tricuspid valve and to evaluate if a novel echocardiography based tricuspid valve nomenclature can also be understood anatomically. Tricuspid valves of 60 non-embalmed human body donors without a medical history of pathologies or macroscopic malformations of the heart were included. Length, height and surface area of leaflets were measured. The valves were morphologically classified according to a novel echocardiography-based classification, in which 6 types are distinguished: classic three-leaflet configuration, bicuspid valves, valves with one leaflet split into two scallops or leaflets and valves with two leaflets divided into two scallops or leaflets. We found a true three leaflet configuration in only 19 (31.7%) of valves. 5 (8.3%) had a two leaflet configuration with a fused anterior and posterior leaflet. Of those 3 had a divided septal leaflet. 4 valves (6.7%) with a divided anterior leaflet, 17 (28.3%) with a divided posterior leaflet, 6 (10%) with a divided septal leaflet and 9 (15.0%) with two leaflets divided. Overall 39 (65%) of valves have at least one leaflet that is divided. In 22 (36.7%) specimens the leaflet was divided into true leaflets and in 17 (28.3%) into scallops. In addition, we could identify 9 (15%) valves having one leaflet divided not only in two but three scallops or leaflets. This study provides further anatomical insight for the significant variability in the morphology of the tricuspid valve. By updating the understanding of its morphological characteristics, this study equips clinicians with valuable insights to effectively advance surgical and interventional treatment of tricuspid valves.

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© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.