Catheter-based treatment of tricuspid regurgitation: state of the art

Figures

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  Figure 1. Annual trends in surgical volume and mortality for isolated tricuspid valve surgery. As the total amount of both isolated tricuspid valve replacement and repair has risen in from 2004 to 2013, in-hospital mortality has held steady in a median 8.8% ratio. Reproduced with permission from (6).

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  Figure 2. Anatomy of tricuspid valve and surrounding structures. Yellow triangle depicts the triangle of Koch, delineated by the septal leaflet, the tendon of Toaro and the coronary sinus. The star marks the location of the atrioventricular node. Reproduced with permission from (9).

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  Figure 3. Stepwise heart team decision-making for treatment of tricuspid regurgitation. The implementation of a complete patient risk stratification in addition to a comprehensive imaging work-up for the assessment of cardiac pathological remodeling may aid in the accurate heart team to provide appropriate treatment (surgical, minimal invasive surgical, transcatheter, pharmacological, or palliative). Reproduced with permission from (14).

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  Figure 4. Transcatheter tricuspid repair devices. There are several techniques to percutaneously repair tricuspid regurgitation, which can be classified according to its anatomic target. In the illustration, examples of coaptation devices [MitraClip (A), PASCAL (B)], suture annuloplasty [TriAlign (C), TriCinc (D)] and ring annuloplasty [Milipede IRIS (E), Cardioband (F)]. Reproduced with permission from (26).

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  Figure 5. Transcatheter tricusdid replacement devices. Current TTVR prosthesis. (A) Navigate; (B) LUX-Valve; (C) Trisol. Reproduced with permission from (69).

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  Figure 6. Heterotopic caval valve devices. Current prosthesis for heterotopic caval valve implantation: (A) Edwards Sapien 3; (B) TricValve; (C) Tricento. Reproduced with permission from (74).

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  Figure 7. Algorithm for transcatheter tricuspid valve repair in different stages. CAVI, caval valve implantation; FTR, functional tricuspid regurgitation; PH, pulmonary hypertension; TA, tricuspid annulus; TTVR, transcatheter tricuspid valve replacement. Adapted with permission from (16).