Percutaneous Treatment Options for Tricuspid Regurgitation Therapy

Purpose of Review: To provide an updated overview of recent advancements in transcatheter solutions for tricuspid regurgitation (TR), focusing on transcatheter edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR), evaluating their efficacy, safety profiles, and future directions. Recent Findings: The TRILUMINATE Pivotal trial showed that T-TEER with the TriClip device significantly reduced TR severity, with 89% of patients achieving ≤ moderate TR at one year, and improved quality of life scores. The TRISCEND II trial demonstrated that TTVR with the EVOQUE system led to 95% of patients achieving TR ≤ mild at one year. However, TTVR was associated with higher procedural risks, including a 10% rate of severe bleeding and a 25% rate of new pacemaker implantation. Summary: High-quality evidence from recent randomized trials confirms the benefits of transcatheter tricuspid interventions. T-TEER offers symptomatic improvement with an excellent safety profile, though residual TR may persist. TTVR provides substantial TR reduction but with increased procedural risks. The current risk-benefit profile of these modalities supports T-TEER as a first line approach when feasible. Future research should focus on optimizing patient selection, refining device designs to reduce complications, and conducting long-term studies on hard endpoints such as survival and heart failure hospitalizations to fully assess the impact of these therapies on patient outcomes.