The present article proposes a standardised approach to evaluate patients with TR who may be candidates for transcatheter interventions. Dedicated expertise and an interdisciplinary Heart Team evaluation are essential to integrate these new techniques successfully and select patients. The recently introduced transcatheter tricuspid valve interventions aim to address this unmet need. Interventions to correct TR are underutilised in daily clinical practice owing to increased surgical risk and late patient presentation. This vicious circle translates into impaired survival and increased heart failure symptoms in patients with and without reduced left ventricular ejection fraction. Irrespective of its aetiology, TR leads to volume overload and increased wall stress, both of which negatively contribute to detrimental remodelling and worsening TR. Secondary TR is more common and arises as a result of annular dilation caused by right ventricular enlargement and dysfunction as a consequence of pulmonary hypertension, often caused by left-sided heart disease or atrial fibrillation. Primary TR results from anatomical abnormality of the tricuspid valve apparatus and is observed in only 8-10% of the patients with tricuspid valve disease. Department of Cardiothoracic Surgery, IRCCS Ospedale San Raffaele, Milan, ItalyĪpproximately 4% of subjects aged 75 years or more have clinically relevant tricuspid regurgitation (TR). Department of Cardiology, St Thomas' Hospital and Cleveland Clinic, London, United Kingdom 13. Cardiology Department, University Hospital Ramón y Cajal, Madrid, and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain 12. Interventional Cardiology Unit, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy 11. Department of Cardiology, University Hospital, Ludwig-Maximilians-Universität München (LMU Munich), Munich, Germany 10. Department of Internal Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany 9. Cardiology Division, Cardiovascular Department, Hospital Papa Giovanni XXIII, Bergamo, Italy 8. Department of Cardiology, Heart Lung Centre, Leiden University Medical Center, Leiden, the Netherlands 7. Cardiology Department, NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA 6. Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany 5. Department of Cardiology, Heart Valve Center, University Medical Center Mainz, Mainz, Germany 4. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, and Istituto Auxologico Italiano, IRCCS, Department of Cardiological, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy 3. Bern University Hospital, University of Bern, Bern, Switzerland 2.
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