Management of Tricuspid Regurgitation: The Role of Transcatheter Therapies

Abstract

Surgical treatment is the gold standard treatment of functional tricuspid regurgitation (FTR) but this carries high risks of morbidity and mortality. Percutaneous procedures are an attractive alternative to surgery for selected patients deemed to be high-risk surgical candidates. A number of tricuspid transcatheter devices have been developed to treat FTR, but at present, evidence of their efficacy and safety is scarce. Preliminary data have shown promising results, but ongoing and future studies will provide a clearer picture of the benefits of these new techniques.

Cardiac implantable electronic device‐induced tricuspid regurgitation: Implications and management

“…Most recently, several transcatheter tricuspid valve intervention (TTVI) techniques have been developed and are currently under investigation. These techniques include annuloplasty devices, leaflet approximation, and transcatheter valve replacement 65 . In an international registry of patients who underwent TTVI, most of which utilized edge‐to‐edge repair techniques, among patients with TR and CIED, acute procedural success and 30‐day outcomes, including residual TR £2, improvement in symptoms, and mortality was similar to patients without CIED 66 .…”

Transcatheter Edge-to-edge Repair of Severe Tricuspid Regurgitation

“…32 In the future, the technique must be refined, and the device be modified for dedicated use for tricuspid valve disease. 33 The optimal clip position strategy for reducing the EROA by closing the valve remains to be established. In an ex vivo pulsatile heart model study, grasping the septal and anterior leaflets allowed for the best post-procedural outcome.…”

Impact of tricuspid annuloplasty device shape and size on valve mechanics—a computational study

“…When leakage is severe, valve repair is required, for which surgical annuloplasty remains the gold standard. 5 During this procedure, a ring-like device is implanted with the intent of restoring the healthy tricuspid annular shape and leaflet coaptation. 6 Today, surgeons can choose from a range of devices that come in different shapes and sizes.…”