Cardiothoracic & vascular anesthesia
Comparison of Preoperative and Intraoperative Assessment of Tricuspid Valve Annular Diameter and Tricuspid Regurgitation Grade by Echocardiography in Patients Undergoing Mitral Valve Surgery
Main finding · Tricuspid annular diameterResult — go to the resultMean paired difference +0.83 mm 95% CI −0.31 to 1.98Authors' conclusion
Although TTE and TEE yield similar mean TAd, per-patient agreement is only moderate. In addition, TR grade is frequently reclassified under anesthesia.
Study context
- Population
- Adults undergoing mitral valve surgery, with or without concomitant tricuspid surgery, single tertiary academic centre
- Participants
- 77 consecutive adults
- Exposure
- TTE vs transesophageal echocardiography (TEE)
- Outcome
- Maximum diastolic tricuspid annular diameter (TAd) and TR grade, TTE vs TEE
Methodological detailssingle-centre, consecutive patients, paired comparison, Bland-Altman analysis
- Single-centre
- Consecutive patients
- Paired comparison
- Bland-Altman analysis
Main finding
Tricuspid annular diameter
Mean paired difference
+0.83 mm
95% CI −0.31 to 1.98
P = 0.152
By group
As reported in the abstract
- TEE tricuspid annular diameter (TAd) decreased vs TTE
- 44 of 77 (57.1%)
- TEE TAd increased vs TTE
- 27 of 77 (35.1%)
- TEE TAd unchanged
- 6 of 77 (7.8%)
- Decreased > increased
- P = 0.009
Observational data: associations, not effects.
Further findings
Tricuspid regurgitation (TR) grade reclassification (TEE vs TTE)
- TR grade distributions differed between modalities
- P = 0.008
- TEE TR severity increased
- 22 of 77 (28.6%)
- TEE TR severity decreased
- 15 of 77 (19.5%)
- TR severity unchanged
- 40 of 77 (51.9%)
TAd correlation
- Pearson r
- 0.526
- Spearman ρ
- 0.521
- Moderate correlation
TAd agreement (Bland-Altman)
- Bias
- +0.83 mm
- Limits of agreement
- −9.05 to +10.71 mm
- Substantial case-level variability
Original publication
Comparison of Preoperative and Intraoperative Assessment of Tricuspid Valve Annular Diameter and Tricuspid Regurgitation Grade by Echocardiography in Patients Undergoing Mitral Valve Surgery. J Cardiothorac Vasc Anesth. Published 11 June 2026. doi:10.
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