Transcatheter Tricuspid Valve Repair or Replacement

Transcatheter tricuspid valve repair or replacement is an emerging alternative to surgical therapy for patients with severe tricuspid regurgitation (TR), particularly those at elevated surgical risk. TR may result from a primary structural abnormality of the tricuspid valve or, more commonly, from secondary annular dilation and leaflet tethering due to right ventricular remodeling associated with left-sided heart failure, pulmonary hypertension, or atrial fibrillation. Surgical intervention for isolated TR is often underutilized due to high perioperative risk and limited referral, highlighting a substantial unmet need for less invasive treatment options. Two transcatheter devices, TriClip™ (Abbott) and EVOQUE™ (Edwards Lifesciences), have been developed to address this gap. TriClip, a transcatheter edge-to-edge repair system, is designed to reduce TR by approximating valve leaflets, while the EVOQUE system provides a complete transcatheter valve replacement through a self-expanding prosthesis anchored within the native valve structure. Both devices are intended for patients with severe symptomatic TR who are not suitable candidates for surgery and continue to experience symptoms despite optimized medical therapy.