Excerpt

In the United States, about 1.6 million patients suffer from moderate to severe tricuspid regurgitation (TR).1 In the majority of these cases (> 90%), regurgitation is functional or, in other words, secondary to the negative remodeling of the right ventricle (RV) and the tricuspid annulus.2 This remodeling may result from left-sided heart disease (e.g., aortic or mitral valve disease or left ventricular dysfunction) or pulmonary hypertension. In the remaining patients, the problem is the tricuspid valve itself. Primary (organic) tricuspid regurgitation can be observed in patients with congenital heart disease (e.g., Ebstein anomaly) or endocarditis, after trauma (e.g., endomyocardial biopsy), or induced by an intracardiac device lead. Treatment of the primary disease in patients with secondary tricuspid regurgitation as well as sufficient diuretic therapy is crucial. Despite the high prevalence, less than 8000 patients per year undergo tricuspid valve surgery.1 Its surgical management precipitates significant perioperative morbidity and mortality due to RV dysfunction and pulmonary hypertension.3 Additionally, timing of surgical intervention remains controversial for different reasons and due to limited data. …