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Transcatheter tricuspid valve intervention: a practical algorithm for patient selection.

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Transcatheter tricuspid valve interventions are emerging for severe tricuspid regurgitation. Current devices show promise, but further research is needed for optimal patient and device selection.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Transcatheter tricuspid valve intervention is expanding globally due to new treatment options for severe tricuspid regurgitation.
  • Devices are classified by mechanism: edge-to-edge leaflet, space occupying, annuloplasty, valve replacement, and caval valve implantation.

Purpose of the Study:

  • To review current transcatheter technologies for tricuspid regurgitation.
  • To summarize early clinical outcomes and factors influencing procedural success.

Main Methods:

  • Review of existing transcatheter tricuspid regurgitation devices and early clinical data.
  • Analysis of patient selection criteria and procedural success factors.

Main Results:

  • Most transcatheter devices for tricuspid regurgitation are investigational with limited evidence.
  • The MitraClip edge-to-edge device is commonly used, effective for smaller coaptation gaps (<7mm).
  • The Tricuspid Cardioband annuloplasty device shows promising short-term results and has CE mark approval.

Conclusions:

  • Patient and device selection for transcatheter tricuspid regurgitation interventions are evolving.
  • Further research is essential to optimize patient selection, timing, and device choice.
  • A proposed algorithm incorporating clinical and anatomical factors aids patient selection.