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The following is a summary of “Eligibility for Transcatheter Tricuspid Valve Interventions in Patients With Tricuspid Regurgitation,” published in the December 2024 issue of Cardiology by Tanaka et al.  

The proportion of people with tricuspid regurgitation (TR) suitable for transcatheter tricuspid valve interventions (TTVI) remains unclear.  

Researchers conducted a retrospective study to assess eligibility for TTVI in people with TR.  

They reviewed the tricuspid valve anatomy of 491 people with TR who were considered for TTVI in local heart team conferences. The anatomical feasibility for transcatheter edge-to-edge repair (T-TEER) was classified into favorable, feasible, and unfavorable groups. Clinical and anatomical eligibility for transcatheter tricuspid valve replacement (TTVR) was evaluated in people with cardiac computed tomography (CCT) images.  

The results showed 491 people, 99 (20.2%) and 235 (47.9%), had favorable and feasible anatomy for T-TEER, respectively, while 157 (32.0%) had unfavorable anatomy for T-TEER. The most common reason for unfavorable anatomy for T-TEER was a large coaptation gap width (66.2%), followed by an anteroposterior TR jet location (62.4%). Among 327 people with CCT images, 205 (62.7%) were judged to be clinically or anatomically ineligible for TTVR, mainly due to tricuspid annuli larger than commercially available prosthesis sizes (65.4%). The combined echocardiographic and CCT assessment showed that 23.2% of people with TR were ineligible for T-TEER and TTVR.  

They concluded that 32.0% of people with TR had unfavorable anatomy for T-TEER, and 37.3% of people with CCT images were eligible for TTVR. Despite advancements in TTVR devices, 23.2% of people remained ineligible for both interventions.  

Source: jacc.org/doi/full/10.1016/j.jcin.2024.09.019