Key result
Standardized stepwise work-up for TR provides practical algorithms and structured protocols for expert center evaluation.
Why the study?
Selecting optimal TR therapy requires an integrated, systematic approach across aetiology, disease stage, comorbidities, operative risk, and anatomical feasibility.
This review provides a standardized stepwise work-up and practical algorithms for the evaluation and management of patients with tricuspid regurgitation, aligning with the 2025 ESC/EACTS Guidelines.
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The availability of transcatheter interventions to treat severe TR has energized the cardiovascular community to improve evaluation and management strategies targeted at this valve lesion”
Encourages standardized TR work-up for timely referral before irreversible damage; leaves open validation of outcome benefits in prospective studies.
Tricuspid regurgitation (TR) is a common yet historically neglected condition associated with poor outcomes. Traditionally managed conservatively, TR has recently gained renewed attention, thanks to advances in surgical and transcatheter interventions. Selecting the optimal therapy, however, requires an integrated and systematic approach considering TR aetiology, stage of the disease, comorbidities, operative risk, and anatomical feasibility. This review describes a standardized stepwise work-up for patients with TR from the referral centre to the expert heart valve centre (HVC). It provides practical algorithms and structured protocols covering clinical and biological assessment, multimodality imaging (echocardiography, computed tomography, cardiac magnetic resonance), and invasive haemodynamic evaluation. The document highlights the importance of multidisciplinary collaboration, involving imagers, heart failure specialists, interventional cardiologists, electrophysiologists, and surgeons, in line with the new recommendations of the 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease. By harmonizing diagnostic standards and promoting a structured approach to patient assessment within HVCs, this review aims to facilitate timely referral and ensure consistent evaluation and management of patients with this complex and often underestimated condition.
Dreyfus et al. (2026) conducted a review in Tricuspid regurgitation. Standardized stepwise work-up was evaluated. A standardized stepwise work-up for patients with tricuspid regurgitation provides practical algorithms and structured protocols for clinical, imaging, and invasive evaluation at expert centers.
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