Percutaneous approaches to functional tricuspid regurgitation

Functional tricuspid regurgitation (TR) is the most frequent etiology of tricuspid valve pathology in Western countries. Surgical avoidance of tricuspid repair has been accepted for years, based on the misleading concept that TR would disappear once the primary left-sided problem is treated. The current prevalence of moderate-to-severe TR is about 1.6 million in the United States, with only a small proportion treated, resulting in a large number of untreated patients with functional TR. Furthermore, signifi cant residual TR has been reported in 10-45 % of patients after tricuspid surgical repair with different techniques. As a result, the pathophysiology and treatment of functional TR has gained signifi cant interest in recent years. Percutaneous procedures may be an attractive alternative to surgery for patients deemed to be high-risk surgical candidates. Some of the concepts that have been developed for the percutaneous treatment of aortic and mitral regurgitation are currently being adapted to percutaneous tricuspid valve procedures.