Percutaneous Tricuspid Repair Techniques

Percutaneous repair or replacement techniques for the aortic and mitral valves have widespread acceptance as effective alternatives for patients who are not surgical candidates. Similar techniques for the tricuspid valve are now on the rise. Tricuspid valve disease is prevalent in a diverse population of patients ranging from 8 to almost 80 years of age. Currently there is a substantial division between the treated and diseased population, with the latter increasing in number. Experience and studies have shown that surgery for moderate or severe tricuspid regurgitation (TR) has a significant negative impact on morbidity and mortality. Progressive TR in itself has been shown to be a risk factor for decreased survival. Percutaneous techniques for management of TR offer these patients an attractive and efficient option. Novel devices have been constructed with the intent to restore the anatomy and physiology of the tricuspid valve complex. TR is most commonly due to secondary causes like left heart failure. Results so far are promising for most devices, and some human trials are underway. In coming years, feasibility and safety data along with experience with these devices will grow. It is possible that percutaneous tricuspid repair may become an alternative for some patients with TR.