Primary Tricuspid Regurgitation: From Neglect to Clinical Relevance.

Area of Science:

• Cardiology
• Valvular Heart Disease
• Medical Imaging

Background:

• Primary tricuspid regurgitation (TR) involves structural abnormalities of the tricuspid valve (TV).
• Historically underestimated, TR is gaining attention due to complex pathophysiology and adverse outcomes.
• Accurate diagnosis and intervention timing, especially in asymptomatic patients, remain challenging.

Purpose of the Study:

• To review current understanding of primary TR's etiology, pathophysiology, diagnosis, and treatment.
• To highlight the importance of personalized medicine in managing primary TR.
• To emphasize the role of advanced imaging in guiding individualized treatment strategies.

Main Methods:

• Review of current literature on primary tricuspid regurgitation.
• Analysis of diagnostic tools, including multimodality imaging (3D echocardiography, cardiac MRI).
• Evaluation of treatment strategies, encompassing surgical and transcatheter therapies.

Main Results:

• Primary TR encompasses diverse etiologies like leaflet prolapse, rheumatic degeneration, and congenital malformations (e.g., Ebstein's anomaly).
• Advances in imaging improve diagnostic accuracy and understanding of TR.
• Transcatheter therapies offer new options for high-risk patients, complementing traditional surgery.

Conclusions:

• Personalized medicine is central to managing primary TR, integrating anatomical, functional, and clinical parameters.
• Tailored treatment decisions, guided by advanced imaging, are crucial for optimizing patient outcomes.
• Further research and awareness are needed for this underrecognized valvular disease.