Management of tricuspid valve regurgitation

Abstract

The tricuspid valve is the right-sided atrioventricular valve, and it is composed of three leaflets (i.e., anterior, posterior, and septal) attached to a fibrous annulus. The cause of tricuspid regurgitation (TR) is more often functional rather than due to a primary valve lesion. Functional TR is due to annular dilatation and secondary to mitral and aortic valvular diseases. Presence of the TR is associated with poor early and late prognosis. Patients with TR have the presenting symptoms of fatigue and weakness related to a reduction in cardiac output. Echocardiography is the best diagnostic method to evaluate TR and associated abnormalities. Tricuspid regurgitation is generally well tolerated. However, in the presence of pulmonary hypertension cardiac output declines and right heart failure worsens. The management depends on the underlying etiology and pathology of the TR. The surgical treatment technique is tricuspid valve annuloplasty rather than valve replacement.