Transcatheter Treatment of Tricuspid Valve Regurgitation

Severe tricuspid regurgitation (TR) is a common valvular heart disease with an incidence of approximately 4% in the adult general population. Most commonly, it results from secondary causes including left ventricular dysfunction, mitral regurgitation and pulmonary arterial hypertension. Isolated severe TR has been identified as an independent predictor of death and cardiac adverse events. Furthermore, TR has been observed to develop late after left-sided valve surgery in up to 10% of patients with adverse impact on clinical outcomes.
Perioperative mortality after surgical correction of TR has been reported to range between 2 and 10%. Moreover, a relevant proportion of patients with TR have already undergone open-heart surgical procedures and reoperation has been associated with an excessive risk of mortality. As a result, less invasive treatment options using transcatheter techniques may address an unmet need among high risk and inoperable patients.
Different concepts for the percutaneous treatment of symptomatic severe TR have been developed including annular reduction, restoration of coaptation, and edge-to-edge repair. Worldwide, an increasing number of patients is treated using these emerging techniques and early clinical results begin to be available.
The purpose of this Research Topic is to provide an overview of the transcatheter solutions developed for the treatment of symptomatic severe TR as well as to describe the challenges of tricuspid valve imaging.