Why the study?
Severe tricuspid regurgitation has been largely undertreated due to high operative risk, and there is a limited evidence base without randomized trials to guide percutaneous management strategies.
Highlights the need for appropriate patient selection and earlier timing for percutaneous tricuspid interventions to improve outcomes in severe tricuspid regurgitation.
May support earlier percutaneous tricuspid intervention in selected severe TR patients; leaves open optimal timing and criteria pending prospective trials.
The tricuspid valve has been neglected for a long time and severe tricuspid regurgitation (TR) was largely undertreated in the past due to a high operative risk. In the last years we observed the development of different less invasive percutaneous options to treat TR. Currently, percutaneous treatments are reserved for high-risk patients presenting with advanced stage disease by which time they are likely to derive a partial benefit at best. There is a limited evidence base, including no randomized trials, to guide the management strategy for severe TR. In the interim we feel that choosing the best device for the most appropriate clinical candidate and with an adequate timing (most probably an "earlier" timing) will be the key combination to improve early and late outcomes of percutaneous treatments.
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Laricchia et al. (2020) studied this question.
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