The forgotten valve. Update on the diagnosis and treatment of tricuspid regurgitation

Abstract

Introduction: Tricuspid valve regurgitation is a common and underdiagnosed pathology, with its prevalence increasing with age. Its progression can lead to right-sided heart failure, increasing mortality rates. Despite its clinical relevance, diagnosis is often made at advanced stages, and few patients receive specific treatment. New percutaneous treatment options have changed the approach to managing this disease.

Objective: This article aims to update the knowledge of the pathophysiology, etiology, diagnosis, and treatment of tricuspid valve regurgitation, highlighting emerging strategies and their impact on patient prognosis.

Methodology: A literature review was conducted in PubMed using search terms related to tricuspid valve regurgitation and its treatments. Randomized controlled trials, observational studies, clinical registries, and recommendations from international guidelines were included.

Results: Tricuspid valve regurgitation is a progressive disease that generates ventricular remodeling and right-sided heart dysfunction. Its initial symptoms are nonspecific but gradually evolve into peripheral edema and signs of venous congestion. The etiology may be primary, secondary to atrial dilation, or secondary to ventricular dilation, which affects the prognosis. Echocardiography is the main diagnostic tool, and percutaneous therapies have gained relevance. Edge-to-edge repair with devices such as TriClip has shown improvement in quality of life, while transcatheter valve replacement is considered an option in advanced cases.

Conclusion: Severe tricuspid valve regurgitation has a significant impact on morbidity and mortality. Early diagnosis and timely referral to specialized centers are essential for proper management. Therapeutic options have evolved toward interventional techniques that improve quality of life and may reduce mortality.