[Percutaneous treatment of severe tricuspid regurgitation: indications and therapeutic options through two clinical cases]

Abstract

Severe tricuspid regurgitation, considered a benign condition for decades, is now recognized for its significant impact on morbidity, mortality and quality of life. Despite this awareness, management often remains limited to symptomatic treatment with diuretics while surgery is rarely proposed due to a high operative risk approaching 10%. In this context transcatheter therapies have gained considerable momentum and represent a credible therapeutic alternative for high-risk patients. Among the emerging strategies, two techniques are predominant: edge-to-edge repair, the most extensively studied to date and now well established and transcatheter tricuspid valve replacement whose clinical data and visibility are steadily increasing owing to promising results. Therapeutic decision-making relies on a multidisciplinary evaluation incorporating clinical parameters, multimodality imaging and detailed valvular morphology. Two clinical cases are presented to illustrate the key factors guiding indication and procedural strategy for each approach.

Keywords: Edge-to-edge repair; Insuffisance tricuspide; Remplacement valvulaire tricuspide; Réparation bord-à-bord; TEER; TTVR; Traitement percutané; Transcatheter therapy; Transcatheter tricuspid valve replacement; Tricuspid regurgitation.