Right ventricular dysfunction in structural tricuspid interventions

With the growing global adoption of transcatheter tricuspid valve intervention (TTVI) and the increasing number of available devices, a comprehensive understanding of right heart dysfunction has become essential. Right heart dysfunction is frequently observed both before and after TTVI and is associated with adverse clinical outcomes. Therefore, a thorough understanding of right heart anatomy and physiology is critical for accurately assessing its pathological states. This review synthesizes current knowledge by integrating findings from major landmark studies on TTVI, with a focus on the available assessment tools for predicting patient outcomes. The anatomy section systematically reviews each component of the right heart-the right atrium, right ventricle, tricuspid valve, and pulmonary valve -while the physiology section emphasizes microstructural characteristics and the pressure-volume relationships. In addition, recommendations from the Tricuspid Valve Academic Research Consortium and the imaging parameters used in recent studies are discussed. Finally, future directions for imaging-based assessment of right heart function in the context of TTVI are highlighted.