Current Evidence on Tricuspid Regurgitation Interventions in Heart Failure

Moderate or severe tricuspid regurgitation (TR) is seen in up to a quarter of patients with chronic heart failure (HF) and exceeds 50% in those with advanced HF symptoms. In patients with HF, the increasing severity of TR is associated with progressively worse survival. Data supporting the medical management of HF and TR continue to evolve with a greater appreciation of the pathophysiologic relationship between these diseases. The results of isolated tricuspid valve surgery vary based on the timing of the intervention and coexisting comorbidities. However, earlier intervention with timing optimized by the use of risk scores may improve these outcomes. Transcatheter tricuspid valve interventions have become a viable therapeutic option, particularly for high surgical risk patients, with a repair and replacement device currently commercially available, but they have yet to show mortality or HF hospitalization benefit. The timing and type of intervention as well as the expected clinical benefit of device therapy require further study.