Right ventricle assessment before tricuspid valve interventions

Area of Science:

• Cardiology
• Cardiac Surgery
• Echocardiography

Background:

• Current ESC/EACTS guidelines prioritize tricuspid annular dilatation for intervention in valvular heart disease.
• Comprehensive right ventricular (RV) assessment is vital for patients with severe tricuspid regurgitation (TR) who may benefit from interventions.
• Existing guidelines lack specific thresholds for RV dysfunction, complicating intervention decisions.

Approach:

• This review synthesizes current evidence on the prognostic significance of RV function.
• It examines the role of various RV parameters in patient selection for tricuspid valve interventions.
• The focus is on percutaneous and surgical treatment strategies for severe TR.

Key Points:

• Tricuspid annular dilatation is the primary guideline parameter for intervention, despite RV dysfunction and pulmonary hypertension being critical.
• Accurate assessment of RV function remains challenging, hindering the establishment of intervention thresholds.
• RV function significantly impacts outcomes in patients undergoing tricuspid valve interventions.

Conclusions:

• RV function and dilatation are crucial prognostic indicators in severe tricuspid regurgitation.
• Integrating RV assessment into decision-making can optimize patient selection for tricuspid valve interventions.
• Further research is needed to establish clear thresholds for RV dysfunction in guiding interventions.