Transcatheter Tricuspid Valve Replacement: Case Selection, Technical Considerations, and Procedural Planning.

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Tricuspid regurgitation (TR) is a prevalent valvular heart disease, particularly in older adults, with severe cases leading to poor prognosis.
• Surgical intervention for the tricuspid valve (TV) is recommended for severe TR patients undergoing left-sided valve procedures.
• Transcatheter tricuspid valve (TV) repair and replacement offer alternatives for patients unsuitable for surgery.

Purpose of the Study:

• To review the current landscape and considerations for transcatheter tricuspid valve (TV) repair.
• To highlight the importance of patient selection and multimodality imaging in transcatheter TV interventions.
• To provide an overview of emerging transcatheter TV technologies.

Main Methods:

• Review of existing literature on transcatheter tricuspid valve (TV) repair.
• Discussion of patient selection criteria, including anatomical, hemodynamic, and comorbidity assessments.
• Description of procedural aspects, access routes, and imaging modalities for transcatheter TV repair.

Main Results:

• Transcatheter TV repair has shown feasibility and efficacy in small studies for severe symptomatic TR.
• Successful transcatheter TV repair hinges on careful patient selection and comprehensive functional assessment.
• Advanced imaging is vital for TR diagnosis, anatomical evaluation, and assessment of cardiac structures.

Conclusions:

• Transcatheter TV repair is a viable option for select patients with severe symptomatic TR.
• Meticulous patient selection and the use of multimodality imaging are paramount for successful outcomes.
• Ongoing clinical trials are evaluating novel prosthetic valves for transcatheter TV interventions.