We used Doppler ultrasonography to study hepatic and portal venous flow patterns in 12 patients
with tricuspid regurgitation (TR) before and after surgery. Before surgery, TR patients showed
marked hepatic vein regurgitation, definite portal flow pulsation, and significant elevation in the
pulsatility (PI) and resistance (RI) indices for both vessels compared with healthy control subjects.
Reverse-flow signals were obtained from the right anterior portal branch and the main portal vein as
well as the hepatic vein. After surgery, the reverse flow in the hepatic vein decreased with the
reduction in TR, and the portal flow changed from a pulsatile to a constant flow pattern. These results
indicate that portal flow is greatly affected by right heart hemodynamics and that there is a close
correlation in blood flow between the hepatic and portal veins mediated by the liver sinusoid.