Key result
Severe RV dysfunction is linked to higher mortality and poor outcomes following tricuspid valve intervention.
Why the study?
Despite the recognized importance of right ventricular evaluation, challenges in assessing right ventricular function limit the use of right ventricular markers in decision-making for tricuspid valve interventions.
Comprehensive multimodality right ventricular assessment is essential prior to tricuspid valve interventions, as right ventricular dysfunction significantly limits procedural benefits and worsens survival.
RV dysfunction may inform risk stratification before tricuspid interventions; leaves open prospective validation of thresholds and multimodality assessment.
In the latest ESC/EACTS Guidelines for the Management of Valvular Heart Disease, right ventricular dilatation and dysfunction, severe pulmonary hypertension and tricuspid annulus dilatation were reported to be the most important parameters to consider in patient selection for tricuspid valve interventions. Indeed, comprehensive right ventricular assessment is crucial in patients with severe tricuspid regurgitation who may benefit from transcatheter or surgical procedures. However, the only guideline parameter considered for intervention has been tricuspid annular dilatation in the presence of at least mild to moderate tricuspid regurgitation, with no other right ventricular markers used in the decision-making process for invasive treatment. Notably, challenges in the assessment of right ventricular function may limit establishing thresholds for defining right ventricular dysfunction. The aim of this review is to summarize current evidence on the prognostic significance of right ventricular function in patients with tricuspid regurgitation undergoing percutaneous or surgical interventions.
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Cersosimo et al. (2023) conducted a review in Severe tricuspid regurgitation. Right ventricular dysfunction was evaluated. Severe right ventricular dysfunction is a crucial prognostic predictor associated with poor clinical outcomes and increased mortality in patients undergoing percutaneous or surgical tricuspid valve interventions.
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