Transcatheter therapy for tricuspid regurgitation: The surgical perspective.

Abstract:

:Tricuspid regurgitation (TR) remains a complex valve pathology affecting nearly two million people in the United States. Although it can present as a primary valve pathology, TR often presents as a late finding in patients with severe pulmonary disease or end-stage chronic heart failure. Surgical repair of isolated TR or TR from left-sided pathology has been associated with high morbidity and mortality. Furthermore, surgery for patients with TR and advanced cardiac disease has been associated with poor long-term outcomes. In recent years, transcatheter technology has emerged to target high-risk surgical patients with TR. Currently, multiple new transcatheter strategies to treat TR have shown initial benefit. However, further development of this technology is required. The aim of this perspective is to provide an overview of TR pathophysiology and to highlight the successful aspects of surgery for TR that provide insight for further translation of transcatheter strategies for patients with TR. These include replication of successful surgical techniques (ring-based annuloplasty and valve replacement) and the goal of achieving no to minimal residual TR following intervention. Earlier implementation of transcatheter valve repair to minimize TR progression and further development of transcatheter valve replacement strategies are also next steps in the translation of this technology.

journal_name

Prog Cardiovasc Dis

authors

Williams AM,Brescia AA,Watt TMF,Romano MA,Bolling SF

doi

10.1016/j.pcad.2019.11.016

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

473-478

issue

6

eissn

0033-0620

issn

1873-1740

pii

S0033-0620(19)30157-4

journal_volume

62

pub_type

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