Focus on tricuspid valve-the European perspective

Tricuspid regurgitation (TR) affects approximately 4% of individuals over 75 years of age and is associated with substantial morbidity due to heart failure symptoms and frequent hospitalization. In Europe, TR prevalence is expected to rise with an ageing population, contributing to a growing burden on heart failure services. Surgical repair or replacement for isolated TR has been historically underutilized because of high operative risk, however, recent advancements in transcatheter technology have shifted the treatment paradigm. Having once been labelled the forgotten valve, the European interventional cardiology community was suddenly confronted with a number of different devices, all designed to target TR. Having the intrahospital mortality for isolated tricuspid valve surgery in mind, ranging from 8.0% to 12.3%, the initial results of transcatheter therapies with an all-cause mortality of 3.7% at 30 days were promising, although procedural success was achieved in only 62% and cardiac and cerebrovascular major adverse events were as high as 26%. Already, T-TEER constituted the majority of interventions, although miskeyed M-TEER devices were used off-label. Other systems, such as Trialign, TriCinch, FORMA, Cardioband, NaviGate, and caval valve implantation were used distinctively less often.