Transcatheter and surgical treatment of tricuspid regurgitation: Predicting right ventricular decompensation and favorable responders

Abstract

Isolated tricuspid regurgitation (TR) has gained increasing recognition in recent years both in the surgical and in the cardiological community. Left untreated, isolated TR significantly worsens survival. Despite being a strong predictor of negative prognosis, interventions to correct TR are rarely performed due to increased surgical risk and late patient presentation. Recently, the ultimate focus has been on patient selection, surgical or transcatheter indication, and correct timing. Furthermore, of paramount importance is the identification of predictors of outcome following treatment, in order to discriminate between favorable and unfavorable responders and guide the decision-making process of the most adequate treatment for every patient.

The Tricuspid Valve: A Review of Pathology, Imaging, and Current Treatment Options: A Scientific Statement From the American Heart Association

“…31 The degree of RV dysfunction has prognostic implications for patients with TR. 32 The key predictors of adverse post-TV intervention were found to be the RV itself and elevated pulmonary pressures.…”

Tricuspid Valve Academic Research Consortium Definitions for Tricuspid Regurgitation and Trial Endpoints

“… 94 Nonetheless, moderate or more (≥2+) residual TR following device therapy is associated with adverse outcomes. 39 , 95 Given the pitfalls of postdevice quantitative methods depending on device type, 3D-VCA may be an important method for assessing both baseline and postdevice efficacy; however, significant limitations of this method also exist. Precise algorithms to integrate discordant parameters need to be developed and validated.…”