A review of functional tricuspid regurgitation highlights the need for appropriate diagnosis and timely surgical intervention, proposing an algorithm for patient selection.
This review provides an overview of functional tricuspid regurgitation assessment and proposes an algorithm for appropriate patient selection and timing for surgical intervention.
Functional tricuspid regurgitation (FTR) is characterized by structurally normal leaflets and is due to the deformation of the valvulo-ventricular complex. While mild FTR is frequent and usually benign, patients with severe FTR may develop progressive ventricular dysfunction and incur increased mortality. Therefore, FTR should not be ignored, should be appropriately diagnosed and quantified by Doppler echocardiography, and should be evaluated for corrective surgical procedures. At present, referral for surgical correction of FTR is often delayed until patients develop intractable heart failure. However, this strategy frequently translates in poor clinical outcome characterized by notable operative mortality and reduced long-term survival. Appropriate patient selection and proper timing for tricuspid valve (TV) repair or replacement are crucial for optimal outcome, but objective criteria for clinical decison-making remain poorly defined. In the present paper, we review the anatomy of the normal TV, the pathophysiology of FTR, the assessment of its severity and functional significance, and propose an algorithm for selecting patients for surgical treatment.
Badano et al. (2013) conducted a review in Functional tricuspid regurgitation. A review of functional tricuspid regurgitation highlights the need for appropriate diagnosis and timely surgical intervention, proposing an algorithm for patient selection.