Tricuspid valve disease: updates on diagnostic imaging and intervention

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Severe tricuspid regurgitation (TR) increases hospitalization and mortality risks.
• Many patients with severe TR are poor surgical candidates due to high risks.
• Transcatheter tricuspid technologies have advanced significantly, with ongoing trials for repair and replacement.

Purpose of the Study:

• To review the anatomy and hemodynamics of TR.
• To summarize diagnostic imaging modalities and current medical therapy.
• To detail surgical and transcatheter repair/replacement strategies and future innovations.

Main Methods:

• Review of anatomical features and hemodynamic consequences of TR.
• Summary of imaging techniques for diagnosis and management.
• Overview of guideline-directed medical therapy, surgical procedures, and transcatheter therapies in clinical trials.

Main Results:

• Knowledge gaps persist in patient selection, anatomical eligibility, and hemodynamic effects of device implantation.
• Numerous transcatheter tricuspid repair and replacement therapies are being evaluated in randomized controlled trials.
• Future innovations are expected to enhance diagnosis, patient selection, and device development.

Conclusions:

• Transcatheter tricuspid therapies represent a rapidly evolving field for managing severe TR in high-risk patients.
• Addressing current knowledge gaps is crucial for optimizing the use of these novel interventions.
• Continued technological advancement holds promise for improving TR management.