Transcatheter tricuspid valve intervention: A practical algorithm for patient selection

Edwin C. Ho, Geraldine Ong, Neil P. Fam

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations

Abstract

Purpose of reviewWorldwide experience in transcatheter tricuspid valve intervention is increasing as more options become available for the treatment of severe tricuspid regurgitation. These devices can be categorized by their primary mechanism of action, including edge-to-edge leaflet devices, space occupying devices, annuloplasty devices, complete valve replacement and caval valve implantation. This review summarizes the current technologies in use, early clinical results and factors that may affect procedural success.Recent findingsAlmost all transcatheter devices for tricuspid regurgitation are investigational with very limited evidence. The most commonly used device is the MitraClip (Abbott, Santa Clara, CA, USA) edge-to-edge leaflet device, which is often more effective when the leaflet coaptation gap is not too large (ideally under 7 mm). The Tricuspid Cardioband (Edwards Lifesciences, Irvine, CA, USA) annuloplasty device has CE mark approval with promising short-term procedural results. Guideline-based assessment of disease severity and medication optimization is crucial during heart team evaluation of eligibility for intervention.SummaryAlthough important lessons have been learned thus far regarding patient and device selection for transcatheter tricuspid regurgitation interventions, the field remains young and further research is needed to optimize treatment in terms of who, when and with what device. Our proposed algorithm for patient selection based on current knowledge incorporates both clinical and anatomic factors.

Original languageEnglish (US)
Pages (from-to)164-172
Number of pages9
JournalCurrent opinion in cardiology
Volume34
Issue number2
DOIs
StatePublished - 2019
Externally publishedYes

Keywords

  • transcatheter repair
  • tricuspid regurgitation
  • tricuspid valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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