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The tricuspid valve: current perspective and evolving management of tricuspid regurgitation

Jason H Rogers1, Steven F Bolling

  • 1Division of Cardiovascular Medicine, University of Davis Medical Center, 4860 Y St, Suite 2820, Sacramento, CA 95817, USA. jason.rogers@ucdmc.ucdavis.edu

Circulation
|May 28, 2009
PubMed

Insights

Tricuspid regurgitation (TR) is often overlooked but significantly impacts outcomes, especially after mitral valve surgery. New transcatheter therapies are needed to address this neglected valvular heart disease.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Interventional Cardiology

Background:

  • Valvular heart disease diagnosis and treatment are advancing, particularly with percutaneous therapies for aortic, pulmonic, and mitral valves.
  • Tricuspid regurgitation (TR) is frequently caused by tricuspid annular dilation, linked to left-sided heart failure and right ventricular overload.
  • Untreated TR during mitral valve surgery worsens perioperative outcomes, functional class, and survival, and often persists post-surgery.

Purpose of the Study:

  • To review the anatomy, pathophysiology, and mechanical correction of tricuspid regurgitation (TR).
  • To explore the potential for transcatheter therapies in treating TR.
  • To highlight the current neglect of TR despite its clinical significance.

Main Methods:

  • Review of existing literature on tricuspid valve anatomy and TR pathophysiology.
  • Analysis of outcomes associated with untreated or surgically treated TR.
  • Exploration of current and potential future treatment modalities, including percutaneous approaches.

Main Results:

  • TR often results from annular dilation and is not reliably resolved by mitral valve surgery alone.
  • Surgical correction of TR during mitral valve surgery is effective, but reoperation carries high mortality.
  • Emerging transcatheter therapies for mitral regurgitation may necessitate parallel percutaneous approaches for TR.

Conclusions:

  • Tricuspid regurgitation (TR) is a significant clinical problem often undertreated.
  • Effective management of TR, potentially via transcatheter interventions, is crucial for improving patient outcomes.
  • Further research and development of percutaneous TR therapies are warranted.

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