How to Treat Tricuspid Valve Disease: What's New on the Horizon?

Tricuspid regurgitation is frequent and is most often caused by annular dilatation and leaflet tethering from adverse right ventricular remodeling in response to several disease processes (functional tricuspid regurgitation), while primary/organic tricuspid valve regurgitation is less common. Surgical intervention for tricuspid regurgitation is usually performed concomitantly to left-sided heart valve surgery. In isolated significant tricuspid regurgitation, however, many patients are left unoperated as they commonly are considered at very high or prohibitive surgical risk. Moreover, the risk versus benefit data are not as well-established as compared to other valve disease. Multiple novel transcatheter therapies have now begun to emerge with the aim to treat tricuspid regurgitation less invasively. For most new interventional procedures, current trials are designed to prove efficacy and safety. In the foreseeable future, however, patients with significant MR can likely be offered a multifaceted palette of minimally invasive transcatheter options in addition to conventional surgery, which will allow to treat more patients in need. These current developments make tricuspid valve disease and its therapy an exciting field of study.