Abstract
Nowadays, severe symptomatic tricuspid regurgitation (TR) affects millions of persons worldwide. However, the benefit of surgical correction of isolated secondary TR remains controversial because of the increased risk of periprocedural mortality and morbidity. In recent years, novel transcatheter tricuspid valve interventions (TTVI) were developed to treat TR, so that TTVI is currently considered in symptomatic, inoperable, anatomically eligible patients. TTVI can be divided into these five domains: edge-to-edge leaflet repair, tricuspid annuloplasty, caval implants, spacer, and total valve replacement. Each transcatheter intervention needs specific imaging protocols for assessing the anatomical feasibility and consequentially predicting the procedural success. This review summarizes the available multimodality imaging tools for screening patients with TR, and identifies anatomical characteristics to choose the best option for the patient.
Highlights
Interest in the tricuspid valve (TV) has increased over the past two decades, because of the recognition of the progressive nature and clinical impact of secondary tricuspid regurgitation (TR) on outcomes [1, 2]
The current european society of cardiology (ESC)/european association for cardio-thoracic surgery (EACTS) guidelines for the management of valvular heart disease recommend transesophageal echocardiography (TEE) and cardiac CT for detailed anatomical evaluation owing to higher spatial resolution [5]
The tricuspid valve interventions (TTVI) can be divided into these five domains: edgeto-edge repair, tricuspid annuloplasty, caval implants, spacer, and total valve replacement (Figure 7)
Summary
Interest in the tricuspid valve (TV) has increased over the past two decades, because of the recognition of the progressive nature and clinical impact of secondary tricuspid regurgitation (TR) on outcomes [1, 2]. Novel transcatheter tricuspid valve interventions (TTVI) were developed for treating TR, so that the current european society of cardiology (ESC) and the european association for cardio-thoracic surgery (EACTS) guidelines for the management of valvular heart disease consider TTVI in symptomatic and inoperable patients who met anatomical criteria for eligibility [5]. This article reviews the TV anatomy and the available imaging tools for a comprehensive assessment of the valve. It identifies favorable and unfavorable anatomical conditions that can guide the operator to choose the best option for the patient
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