Contemporary review of percutaneous therapy for tricuspid valve regurgitation

Expert Rev Cardiovasc Ther. 2020 Apr;18(4):209-218. doi: 10.1080/14779072.2020.1750370. Epub 2020 Apr 13.

Abstract

Introduction: Moderate to severe tricuspid regurgitation (TR) is a poor prognostic factor regardless of right ventricular function. However, a majority of patients are managed medically rather than undergoing isolated tricuspid valve surgery due to high in-hospital mortality. Percutaneous therapy in the form of transcatheter tricuspid valve repair or replacement is an attractive option for this high risk multimorbid cohort.Areas covered: A literature search was performed for tricuspid valve repair or replacement using MEDLINE, Current Contents Connect, Google Scholar, EMBASE, Cochrane library, PubMed, ScienceDirect, and Web of Science (Till 10/19). This review outlines the anatomical challenges specific to the tricuspid valve, provides an insight into patient selection for percutaneous treatment, and summarizes the current evidence for the available devices.Expert opinion: With the recent understanding that percutaneous repair of TR is feasible and provides better patient outcomes, we must more closely evaluate our patients with tricuspid regurgitation and consider treatment. MitraClip in the tricuspid position (TriClip) is the most widely used TV repair device, and several prospective trials are currently investigating various devices in this arena that hopefully will hopefully provide greater insight into patient selection and anatomically specific device choice.

Keywords: TriClip; Tricuspid valve; tricuspid regurgitation; tricuspid valve repair; tricuspid valve replacement.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / methods
  • Heart Valve Prosthesis Implantation / methods*
  • Hospital Mortality
  • Humans
  • Patient Selection
  • Treatment Outcome
  • Tricuspid Valve / surgery*
  • Tricuspid Valve Insufficiency / physiopathology
  • Tricuspid Valve Insufficiency / surgery*