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Review
. 2024 Apr 8;17(7):837-858.
doi: 10.1016/j.jcin.2024.02.034.

New Approaches to Assessment and Management of Tricuspid Regurgitation Before Intervention

Garrett A Welle  1 , Rebecca T Hahn  2 , Joann Lindenfeld  3 , Grace Lin  4 , Vuyisile T Nkomo  4 , Jörg Hausleiter  5 , Philipp C Lurz  6 , Sorin V Pislaru  4 , Charles J Davidson  7 , Mackram F Eleid  8
Affiliations
Free article
Review

New Approaches to Assessment and Management of Tricuspid Regurgitation Before Intervention

Garrett A Welle et al. JACC Cardiovasc Interv. .
Free article

Abstract

Severe tricuspid regurgitation (TR) is a progressive condition associated with substantial morbidity, poor quality of life, and increased mortality. Patients with TR commonly have coexisting conditions including congestive heart failure, pulmonary hypertension, chronic lung disease, atrial fibrillation, and cardiovascular implantable electronic devices, which can increase the complexity of medical and surgical TR management. As such, the optimal timing of referral for isolated tricuspid valve (TV) intervention is undefined, and TV surgery has been associated with elevated risk of morbidity and mortality. More recently, an unprecedented growth in TR treatment options, namely the development of a wide range of transcatheter TV interventions (TTVI) is stimulating increased interest and referral for TV intervention across the entire medical community. However, there are no stepwise algorithms for the optimal management of symptomatic severe TR before TTVI. This article reviews the contemporary assessment and management of TR with addition of a medical framework to optimize TR before referral for TTVI.

Keywords: transcatheter tricuspid intervention; tricuspid regurgitation; tricuspid valve.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Hahn has received speaker fees from Abbott Structural, Baylis Medical, Edwards Lifesciences, Medtronic, Philips Healthcare, and Siemens Healthineers; has institutional consulting contracts, for which she receives no direct compensation with Abbott Structural, Edwards Lifesciences, Medtronic, and Novartis; and is chief scientific officer for the echocardiography core laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored tricuspid valve trials, for which she receives no direct industry compensation. Dr Lindenfeld has been a consultant for Abbott, Alleviant, AstraZeneca, Boston Scientific, CVRx, Edwards Lifesciences, Medtronic, Merck, V Wave, and Whiteswell; and has grants from AstraZeneca and Volumetrix. Dr Nkomo has been a consultant for UpToDate. Dr Hausleiter has received speaker honoraria and served on advisory boards for Edwards Lifesciences. Dr Lurz has received institutional fees and research grants from Abbott Vascular, Edwards Lifesciences, and ReCor; has received honoraria from Edwards Lifesciences, Abbott Medical, Innoventric, ReCor, and Boehringer Ingelheim; and holds stock options with Innoventric. Dr Davidson has been an unpaid consultant for and received research grant support from Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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