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Isolated Tricuspid Regurgitation: When Is Surgery Appropriate? A State-of-the-Art Narrative Review
Raffaele Barbato1, Francesco Loreni1, Chiara Ferrisi1
1Unit of Cardiac Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Journal of Clinical Medicine
|July 29, 2025
Summary
Tricuspid regurgitation (TR) impacts mortality, yet diagnosis is often delayed. Understanding TR anatomy and pathophysiology is key for timely intervention with new transcatheter treatments.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Tricuspid regurgitation (TR) is increasingly recognized for its association with mortality.
- High in-hospital mortality rates in TR patients stem from late diagnosis and limited surgical options.
- Underestimation of TR severity is linked to incomplete understanding of valvular/ventricular anatomy and disease pathophysiology.
Purpose of the Study:
- To enhance understanding of normal and pathological tricuspid valve anatomy.
- To classify the anatomical causes of tricuspid regurgitation.
- To present novel risk stratification methods for guiding TR treatment timing.
Main Methods:
- Review of current literature on tricuspid valve anatomy and TR.
- Classification of anatomical substrates contributing to TR.
- Evaluation of emerging risk stratification tools for TR management.
Main Results:
- Detailed description of tricuspid valve anatomy and its pathological variations.
- Categorization of TR based on underlying anatomical defects.
- Introduction of new methods for assessing TR severity and patient risk.
Conclusions:
- Accurate anatomical assessment is crucial for diagnosing and managing TR.
- Understanding TR pathophysiology aids in selecting appropriate medical or surgical interventions.
- Emerging transcatheter therapies necessitate precise diagnostic and risk stratification strategies.
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