Tricuspid regurgitation: standardized stepwise work-up from referral to expert heart valve centre
Year: 2026
Type: article
Abstract: Tricuspid regurgitation (TR) is a common yet historically neglected condition associated with poor outcomes. Traditionally managed conservatively, TR has recently gained renewed attention, thanks to advances in surgical and transcatheter interventions. Selecting the optimal therapy, however, requires an integrated and systematic approach considering TR aetiology, stage of the disease, comorbidities, operative risk, and anatomical feasibility. This review describes a standardized stepwise work-up for patients with TR from the referral centre to the expert heart valve centre (HVC). It provides practical algorithms and structured protocols covering clinical and biological assessment, multimodality imaging (echocardiography, computed tomography, cardiac magnetic resonance), and invasive haemodynamic evaluation. The document highlights the importance of multidisciplinary collaboration, involving imagers, heart failure specialists, interventional cardiologists, electrophysiologists, and surgeons, in line with the new recommendations of the 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease. By harmonizing diagnostic standards and promoting a structured approach to patient assessment within HVCs, this review aims to facilitate timely referral and ensure consistent evaluation and management of patients with this complex and often underestimated condition.
Source: European Heart Journal
Authors: Julien Dreyfus, Fabien Praz, Rebecca Hahn, Davide Margonato, Denisa Muraru, David Messika-Zeitoun, Marianna Adamo, Eustachio Agricola, Erwan Donal, Mirjam Wild, Haran Burri, Marco Metra, Augustin Coisne, Karl-Patrik Kresoja, Julia Grapsa, Jeroen Bax, Marta Sitges, Bernard Prendergast, Francesco Maisano, Joao Cavalcante, Nina Ajmone Marsan
Institutions: Centre Cardiologique du Nord, University of Bern, University Hospital of Bern, Columbia University Irving Medical Center, Columbia University, IRCCS Ospedale San Raffaele, Minneapolis Heart Institute Foundation, IRCCS Istituto Auxologico Italiano, University of Milano-Bicocca, University of Ottawa, Ottawa Heart Institute, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Brescia, Vita-Salute San Raffaele University, Inserm, Laboratoire Traitement du Signal et de l'Image, Centre Hospitalier Universitaire de Rennes, Université de Rennes, University of Freiburg, University Medical Center Freiburg, Universitäts-Herzzentrum Freiburg-Bad Krozingen, University Hospital of Geneva, Université de Lille, Institut Pasteur de Lille, Centre Hospitalier Universitaire de Lille, Cardiovascular Research Foundation, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, Brigham and Women's Hospital, Harvard University, Imperial College London, Leiden University Medical Center, Instituto de Salud Carlos III, Centro de Investigación en Red en Enfermedades Cardiovasculares, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Cleveland Clinic London, Abbott Northwestern Hospital, Allina Health
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,922
OpenAlex ID: W7141429765