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J Am Coll Cardiol. 2016 Apr 19;67(15):1829-1845. doi: 10.1016/j.jacc.2016.01.063.

Transcatheter Therapies for Treating Tricuspid Regurgitation.

Author information

1
Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. Electronic address: josep.rodes@criucpq.ulaval.ca.
2
Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York.
3
Interventional Cardiology Unit, Cardiology and Cardiothoracic Surgery Department, San Raffaele University Hospital, Milan, Italy.
4
Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
5
Department of Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
6
Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
7
Albertinen Heart Center and Medicare Center Hamburg, Hamburg, Germany.
8
Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
9
Bichat Claude Bernard Hospital-Paris VII University, Paris, France.

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.

KEYWORDS:

cardiac catheterization; echocardiography; pulmonary hypertension; right ventricular dysfunction; tricuspid valve; tricuspid valve insufficiency

PMID:
27081024
DOI:
10.1016/j.jacc.2016.01.063
[Indexed for MEDLINE]
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