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The role of percutaneous tricuspid regurgitation interventions in the current clinical practice: tackling a heterogenous disease

Severe tricuspid regurgitation (TR) is known to be independently associated with adverse prognosis.1 Its importance is further emphasized by the prevalence of this entity, particularly in the aging population.2 Until the past few years, surgical management was the only available effective treatment for isolated severe TR. Operative mortality, nonetheless, remains high.3 Moreover, surgery is associated with a 45% recurrence rate after 5 years,4 and recent data suggest that surgery may not improve the survival rate in isolated severe cases of TR.5 Accordingly, guidelines recommend TR surgery as a class 1 indication only with concomitant left-sided valvular surgery.6 Conversely, patients with prohibitive surgical risk managed conservatively were shown to have dismal outcomes.7 Fortunately, the emergence of percutaneous devices expanded the horizon of TR treatment.