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Indications, Limitations, and Development of Tricuspid Valve Interventions in Adults

Journal

CANADIAN JOURNAL OF CARDIOLOGY
Volume 38, Issue 10, Pages S66-S78

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.cjca.2021.08.013

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Funding

  1. Montreal Heart Institute

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Tricuspid regurgitation is associated with increased mortality and poor outcomes. There is a lack of sufficient treatment for tricuspid valve diseases. Transcatheter tricuspid valve interventions have emerged as a minimally invasive approach. Short-term results are satisfactory, but durability of the intervention needs to be considered.
Tricuspid regurgitation is associated with excessive mortality and poor outcomes regardless of the cause and associated comorbidities. Despite this clear association with mortality, tricuspid valve diseases remain undertreated. Tricuspid valve surgery, either repair or replacement, has shown little detectable survival benefit. Transcatheter tricuspid valve interventions have emerged as a less invasive approach to tricuspid valve diseases. They can be categorised into coaptation devices, annuloplasty devices, transcatheter tricuspid valve replacement, heterotopic caval valve implantation, and tricuspid valve-invalve. Despite the late referral and the patient's profile, results remain fairly acceptable at least in the short term, with good procedural device success, excellent safety profile, and sustained reduction of tricuspid regurgitation for up to 1 year. Because results are limited to the mid-term, transcatheter tricuspid valve intervention durability will need to be established before broader adoption of these technologies.

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