Grading the severity of TR
Parameters | Mild | Moderate | Severe |
QUALITATIVE | |||
Mitral valve morphology | Normal/Abnormal | Normal/Abnormal | Flail lefleat/ruptured PMs |
Colour flow MR jet | Small, central | Intermediate | Very large central jet or eccentric jet adhering, swirling and reaching the posterior wall of the LA |
Flow convergence zone | No or small | Intermediate | Large |
CW signal of MR jet | Faint/Parabolic | Dense/Parabolic |
Dense/Triangular |
SEMI-QUANTITATIVE | |||
VC width (mm) | <3 | Intermediate | ≥7 (>8 for biplane) |
Pulmonary vein flow | Systolic dominance | Systolic blunting | Systolic flow reversal |
Mitral inflow | A wave dominant | Variable | E wave dominant (>1.5 cm/s) |
TVI mit /TVI Ao | <1 | Intermediate | >1.4 |
QUANTITATIVE | |||
EROA (mm²) | <20 | 20-29; 30-39 | ≥40 |
R vol (mL) | <30 | 30-44; 45-59 | ≥60 |
+LV and LA size and the systolic pulmonary pressure |