Mechanism and Implications of the Tricuspid Regurgitation: From the Pathophysiology to the Current and Future Therapeutic Options

Circ Cardiovasc Interv. 2017 Jul;10(7):e005043. doi: 10.1161/CIRCINTERVENTIONS.117.005043.

Abstract

The tricuspid valve was virtually ignored for a long time in the past. However, significant tricuspid regurgitation (TR) often accompanies left-side heart valve pathology and does not always reverse with its correction. If left untreated, TR can progress and result in progressive right ventricular failure. Current guideline recommendations still hold minor differences. Nevertheless, there is a consensus to operate on patients with severe TR undergoing left-sided valve surgery (class I) or those with mild to moderate TR with a dilated annulus (≥40 or ≥21 mm2, Class IIa). However, in case of the primary TR, surgical options is limited by a relatively high risk of mortality and morbidity. For these patients, new percutaneous approaches are becoming available but no long-term data are still available. In this review, we provide a comprehensive overview of the epidemiological and pathophysiological aspects of TR, and the current and future directions of therapy.

Keywords: heart failure; right ventricular dysfunction; tricuspid valve; tricuspid valve regurgitation.

Publication types

  • Review

MeSH terms

  • Cardiac Valve Annuloplasty* / adverse effects
  • Cardiac Valve Annuloplasty* / instrumentation
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis Implantation* / instrumentation
  • Hemodynamics
  • Humans
  • Prosthesis Design
  • Recovery of Function
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome
  • Tricuspid Valve / physiopathology*
  • Tricuspid Valve / surgery*
  • Tricuspid Valve Insufficiency / diagnosis
  • Tricuspid Valve Insufficiency / epidemiology
  • Tricuspid Valve Insufficiency / physiopathology*
  • Tricuspid Valve Insufficiency / surgery*