Tricuspid regurgitation: when is it time for surgery?

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Cardiac Imaging

Background:

• Growing interest in surgical tricuspid regurgitation (TR) treatment due to early intervention trends and minimally invasive techniques.
• Lack of definitive evidence on optimal timing for functional TR (outside left-sided surgery) and primary TR intervention.
• Need for updated guidance on tricuspid valve management.

Purpose of the Study:

• To present the state-of-the-art in surgical tricuspid regurgitation intervention.
• To review indications, optimal timing, surgical options, and outcomes for TR.
• To discuss the role of transcatheter tricuspid valve intervention.

Main Methods:

• Review of current literature and expert opinion on tricuspid regurgitation management.
• Analysis of factors influencing timing and indications for intervention.
• Evaluation of surgical and transcatheter treatment modalities.

Main Results:

• Indications and timing for tricuspid valve invasive management depend on patient characteristics, disease stage, and anatomy.
• Early intervention before severe right ventricle dysfunction and pulmonary hypertension is associated with better outcomes.
• Transcatheter techniques are emerging as viable alternatives for inoperable or high-risk patients.

Conclusions:

• Optimal timing for tricuspid regurgitation intervention is crucial for improved surgical outcomes.
• Transcatheter tricuspid valve interventions represent a significant advancement for specific patient groups.
• Further research is needed to refine guidelines for tricuspid regurgitation management.