Transcatheter Tricuspid Valve Replacement: A Feasible Solution to a Real-world Problem

Area of Science:

• Cardiology
• Interventional Cardiology
• Valvular Heart Disease

Background:

• Moderate-to-severe tricuspid regurgitation (TR) is a prevalent condition linked to increased mortality.
• Current management of TR is often conservative due to diagnostic challenges, disease progression, comorbidities, and surgical risks.
• Transcatheter tricuspid valve replacement (TTVR) presents an innovative approach to address these limitations in TR management.

Purpose of the Study:

• To review the pathophysiology and current management of TR.
• To highlight the role and potential of TTVR in treating symptomatic TR.
• To discuss perioperative considerations, imaging modalities, and available/investigational TTVR devices.

Main Methods:

• Overview of TR pathophysiology and its management implications.
• Review of current TR management strategies and their limitations.
• Detailed examination of TTVR, including patient selection, multimodality imaging, available devices, and clinical trial data.

Main Results:

• TTVR is rapidly advancing as a treatment for severe symptomatic TR.
• Currently available devices show promising results, with ongoing development for future innovations.
• Real-world experiences are crucial for refining TTVR and establishing long-term safety and efficacy.

Conclusions:

• TTVR is a significant innovation in managing severe symptomatic tricuspid regurgitation.
• Continued research and data collection are essential to fully understand the long-term safety and efficacy of TTVR.
• Lessons learned from current TTVR procedures will guide the development of definitive solutions for TR patients.