Tricuspid annular plane systolic excursion (TAPSE) is a quantitative echocardiography technique to assess right ventricular (RV) systolic function. As an intensivist, I obtain an apical four-chamber view using transthoracic echocardiography, activate motion (“M”) mode through the lateral tricuspid valve (TV) annulus, and measure the peak-to-trough distance. A value > 18 mm suggests normal RV function.

As a cardiac anesthesiologist, I utilize transesophageal echocardiography (TEE) to guide intraoperative decision-making. Although the lateral aspect of the TV can be assessed from the midesophageal 4-chamber view, the measurement almost always requires angle correction as the interrogation beam and vector of tricuspid annular motion > 30°.

My preference is to perform TAPSE from the transgastric RV inflow view as the lateral annulus moves more in line with the M-mode beam thereby reducing error.

Here’s an example of the M-mode TAPSE profile obtained from the transgastric view.

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