title: Transcatheter Therapies for Treating Tricuspid Regurgitation.
abstract: Tricuspid valve (TV) disease has been relatively neglected, despite the known association between severe tricuspid regurgitation (TR) and mortality. Few patients undergo isolated tricuspid surgery, which remains associated with high in-hospital mortality rates, particularly in patients with prior left-sided valve surgery. Patients with severe TR are often managed medically for years before TV repair or replacement. Current guidelines recommend TV repair in the presence of a dilated tricuspid annulus at the time of a left-sided valve surgical intervention, even if regurgitation is mild. This proposed algorithm aims to prevent the inevitable progression to severe TR and the need for a second surgical intervention. Recently, novel transcatheter treatment options were developed for treating patients with severe TR and right heart failure with prohibitive surgical risk. Here we describe currently available transcatheter treatment options for severe TR implanted at different levels: the junction between vena cavae and right atrium; the tricuspid annulus; or between TV leaflets, improving coaptation.
authors.affiliation: Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. Electronic address: josep.rodes@criucpq.ulaval.ca.
authors.forename: Josep
authors.initials: J
authors.lastname: Rodés-Cabau
authors.affiliation: Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York.
authors.forename: Rebecca T
authors.initials: RT
authors.lastname: Hahn
authors.affiliation: Interventional Cardiology Unit, Cardiology and Cardiothoracic Surgery Department, San Raffaele University Hospital, Milan, Italy.
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.affiliation: Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Laule
authors.affiliation: Department of Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lauten
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.affiliation: Albertinen Heart Center and Medicare Center Hamburg, Hamburg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Schofer
authors.affiliation: Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
authors.forename: Francisco
authors.initials: F
authors.lastname: Campelo-Parada
authors.affiliation: Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
authors.forename: Rishi
authors.initials: R
authors.lastname: Puri
authors.affiliation: Bichat Claude Bernard Hospital-Paris VII University, Paris, France.
authors.forename: Alec
authors.initials: A
authors.lastname: Vahanian
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D018450:Disease Progression; D004452:Echocardiography / Q000379:methods; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D017052:Hospital Mortality; D006801:Humans; D020379:Risk Adjustment; D012720:Severity of Illness Index; D061665:Time-to-Treatment; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery
keywords: cardiac catheterization; echocardiography; pulmonary hypertension; right ventricular dysfunction; tricuspid valve; tricuspid valve insufficiency