Transcatheter Tricuspid Valve Therapy

Abstract

Purpose of review: Despite the increasing prevalence of tricuspid regurgitation (TR) and its association with poor survival, isolated tricuspid valve (TV) surgery remains infrequent. To address this unmet clinical need, several less invasive transcatheter TV therapies have emerged as an alternative to surgery in high-risk patients with severe functional TR. The objective of this review is to summarize the current progress and future directions in the field of transcatheter TV therapies.

Recent findings: Transcatheter TV repair devices are aimed at improving leaflet coaptation either directly by bringing the leaflets together or indirectly by addressing the dilated annulus. Transcatheter TV replacement, on the other hand, can be orthotopic (implantation of prosthetic valve in an anatomically correct position in the tricuspid annulus) or heterotopic (implantation of prosthetic valve in a different anatomic location to counter the hemodynamic and clinical consequences of severe TR). Data from first-in-man and phase 1/2 clinical studies on the safety and efficacy of various transcatheter TV therapies appear promising. Technological advancement and increased experience are anticipated to improve outcomes of transcatheter TV therapy in the coming years. Ongoing and future studies should focus on careful patient selection, optimal timing of intervention, and long-term clinical outcomes and device durability.

Keywords: Transcatheter tricuspid valve therapy; Tricuspid regurgitation; Tricuspid valve; Valvular heart disease.