Guiding Interventions for Secondary Tricuspid Regurgitation: Follow the Intricate Interplay between Form and Function

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Secondary tricuspid regurgitation (TR) has long been considered a benign and well-Tolerated valvular lesion that resolves after treatment of the underlying disease. This view has been challenged by data indicating that long-standing TR can be a progressive disorder, contributing to right ventricular failure and end-organ damage, despite adequate treatment of the underlying disease. Surgical correction is curative, but infrequently performed and historically associated with poor outcomes. This may be due to delayed diagnosis, lack of well-defined surgical indications, and, consequently, late intervention in patients in poor clinical condition with failing right ventricles. Because of limited evidence about timing and corresponding outcome of tricuspid valve surgery, current guideline recommendations are rather conservative and show several inconsistencies. Nevertheless, there has been a trend toward a more aggressive approach in the surgical treatment of TR with improved outcomes. Moreover, emerging transcatheter options claim to provide a lower-risk alternative for selected patients. This may facilitate earlier treatment and improve the attitude toward an early treatment strategy of secondary TR, yet is not reflected in the guidelines. Future research is needed for risk stratification to determine inclusion criteria and optimal timing for intervention.

Original languageEnglish
Pages (from-to)7-15
Number of pages9
JournalCardiology in Review
Issue number1
Publication statusPublished - 1 Jan 2023

Bibliographical note

Funding Information:
R.S.A.S. has received funding from the OUTREACH consortium of the Netherlands Heart Institute.

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.


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