Tricuspid Valve Interventions (TTVR / TEER / TriClip)

Tricuspid Valve Interventions are advanced catheter-based treatments for significant tricuspid valve disease, particularly severe tricuspid regurgitation. TTVR replaces the diseased tricuspid valve using a transcatheter replacement valve. TEER repairs the valve by bringing portions of the valve leaflets together. TriClip is a dedicated clip-based system used for tricuspid edge-to-edge repair. Patients may experience symptoms such as swelling of the legs, abdominal fluid retention, fatigue, breathlessness and reduced exercise tolerance. Treatment may be considered when significant tricuspid regurgitation causes persistent symptoms despite appropriate medical treatment. TTVR may be considered when the tricuspid valve anatomy is suitable for transcatheter replacement, particularly in selected patients who have increased risk associated with conventional surgery or whose anatomy may be less suitable for repair. TEER or TriClip may be considered for selected patients with significant or severe tricuspid regurgitation whose valve anatomy is suitable for edge-to-edge repair. The procedure attempts to reduce backward blood flow while preserving the patient's native valve. Before treatment, the Heart Team evaluates the severity of tricuspid regurgitation, valve anatomy, leaflet mobility, coaptation gap, annulus size, right ventricular function, pulmonary pressure, existing pacemaker or ICD leads, previous heart procedures and overall surgical risk. The procedure is performed using catheter-based vascular access, generally through a vein. The device is advanced toward the heart under imaging guidance. During TEER or TriClip, the repair device grasps and approximates appropriate portions of the valve leaflets. During TTVR, a replacement valve is deployed in the tricuspid valve position. After the procedure, patients are monitored for heart rhythm, blood pressure, fluid balance, right ventricular function, vascular access complications and valve function. Follow-up echocardiography may be used to assess the treated valve and heart function. The choice between medical treatment, TEER, TriClip, TTVR and conventional surgery is individualised for every patient. A detailed clinical and imaging assessment by an experienced structural heart team is important before selecting the treatment approach.