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Transcatheter Tricuspid Valve Replacement: Principles and Design
Ozan M Demir1,2, Damiano Regazzoli1, Antonio Mangieri1
1Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.
Frontiers in Cardiovascular Medicine
|October 5, 2018
Summary
Severe tricuspid regurgitation (TR) affects millions, yet few receive treatment. This review explores emerging transcatheter devices and techniques for TR, addressing a critical unmet clinical need.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Tricuspid regurgitation (TR) is highly prevalent, affecting up to 85% of the population, with over 1.6 million individuals in the US experiencing moderate-to-severe TR.
- Despite its prevalence and association with poor outcomes, only approximately 8,000 tricuspid valve operations are performed annually in the US, highlighting a significant gap in care.
- Existing percutaneous transcatheter therapies for other valvular diseases have advanced significantly, but similar progress for the tricuspid valve has lagged until recently.
Purpose of the Study:
- To review the principles and emerging landscape of transcatheter tricuspid valve replacement (TTVR) for treating severe tricuspid regurgitation.
- To analyze the currently available and developing transcatheter devices for TTVR.
- To outline the procedural challenges and considerations for TTVR.
Main Methods:
- This review synthesizes current literature and expert insights on transcatheter interventions for tricuspid regurgitation.
- It analyzes the technical aspects of TTVR procedures.
- The review examines various transcatheter devices designed for tricuspid valve repair and replacement.
Main Results:
- The prevalence of tricuspid regurgitation is substantial, with a notable disparity between the number of affected individuals and those undergoing surgical intervention.
- Recent advancements have introduced novel transcatheter devices and approaches for TTVR, offering new therapeutic options.
- The review identifies key challenges in TTVR, including device selection, imaging guidance, and procedural execution.
Conclusions:
- There is a pressing clinical need for effective treatments for severe tricuspid regurgitation, given its high prevalence and associated morbidity.
- Transcatheter tricuspid valve replacement is an emerging field with promising new devices and techniques.
- Further research and clinical experience are necessary to optimize TTVR procedures and overcome existing challenges.
Keywords:
cardiac imagingstructural heart diseasetricuspid regurgitationtricuspid valvevalve replacementMore Related Videos
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