Recent advances in predicting and improving outcomes in patients undergoing transcatheter tricuspid valve intervention.

Abstract

Tricuspid regurgitation (TR) has long been underestimated, traditionally viewed as a benign condition, yet contemporary evidence demonstrates its high prevalence and substantial adverse prognostic implications. Medical therapy remains limited, and although surgery has historically been the standard of care, many patients are referred at advanced stages, contributing to poor operative outcomes. Transcatheter tricuspid valve interventions (TTVI) have emerged as a valuable therapeutic option, showing consistent improvements in symptoms, quality of life (QoL), and heart failure hospitalizations (HFH), although a definitive survival benefit has not yet been established. Optimal management requires a comprehensive, multiparametric, and multidisciplinary approach. Key elements include careful assessment of TR etiology, clinical status, right heart failure stage, multimodality imaging, risk scores, and invasive hemodynamics. Integrating these factors enables appropriate patient selection, individualized treatment strategies, and avoidance of futile procedures. Ultimately, decisions regarding intervention and device choice should be guided by a dedicated multidisciplinary Heart Team within a specialized Heart Valve Center.