Abstract：
OBJECTIVE: This review addresses treatment options for moderate to severe tricuspid valve regurgitation and the importance of right ventricular function and the pulmonary circulation.
RESULTS: Several interventional treatment options for severe tricuspid regurgitation have been developed including transcatheter edge-to-edge repair, annuloplasty and valve replacement. So far, transcatheter edge-to-edge repair is most frequently used with procedural success rates of more than 95% and improvements in functional and quality of life parameters for up to 2 years. Right ventricular function as well as pulmonary artery pressure and resistance levels are important outcome predictors. Mean pulmonary artery pressure more than 30 mmHg, transpulmonary gradient more than 17 mmHg and right ventricular to pulmonary artery coupling ratio less than 0.406 indicate poor outcome.
CONCLUSIONS: Despite the remarkable safety of interventional treatment of severe tricuspid regurgitation right ventricular dysfunction and abnormal pulmonary hemodynamics are important determinants of procedural success and clinical outcome.Complete hemodynamic work-up should be an integral part of prerepair assessment although validated data predicting outcome are limited.
RESULTS: Several interventional treatment options for severe tricuspid regurgitation have been developed including transcatheter edge-to-edge repair, annuloplasty and valve replacement. So far, transcatheter edge-to-edge repair is most frequently used with procedural success rates of more than 95% and improvements in functional and quality of life parameters for up to 2 years. Right ventricular function as well as pulmonary artery pressure and resistance levels are important outcome predictors. Mean pulmonary artery pressure more than 30 mmHg, transpulmonary gradient more than 17 mmHg and right ventricular to pulmonary artery coupling ratio less than 0.406 indicate poor outcome.
CONCLUSIONS: Despite the remarkable safety of interventional treatment of severe tricuspid regurgitation right ventricular dysfunction and abnormal pulmonary hemodynamics are important determinants of procedural success and clinical outcome.Complete hemodynamic work-up should be an integral part of prerepair assessment although validated data predicting outcome are limited.
摘要：
目的：本综述讨论了中度至重度三尖瓣反流的治疗选择以及右心室功能和肺循环的重要性。
结果：已经开发了几种严重三尖瓣返流的介入治疗方案，包括经导管边缘到边缘修复，瓣环成形术和瓣膜置换术。到目前为止,最常用的是经导管边缘到边缘修复,手术成功率超过95%,功能和生活质量参数改善长达2年.右心室功能以及肺动脉压力和阻力水平是重要的预后预测因子。平均肺动脉压超过30mmHg,经肺压差大于17mmHg,右心室与肺动脉耦合比小于0.406表明预后不良.
结论：尽管严重三尖瓣返流的介入治疗具有显著的安全性，但右心室功能障碍和肺血流动力学异常是手术成功和临床结局的重要决定因素。完整的血液动力学检查应该是修复前评估的组成部分，尽管预测结果的有效数据有限。
结果：已经开发了几种严重三尖瓣返流的介入治疗方案，包括经导管边缘到边缘修复，瓣环成形术和瓣膜置换术。到目前为止,最常用的是经导管边缘到边缘修复,手术成功率超过95%,功能和生活质量参数改善长达2年.右心室功能以及肺动脉压力和阻力水平是重要的预后预测因子。平均肺动脉压超过30mmHg,经肺压差大于17mmHg,右心室与肺动脉耦合比小于0.406表明预后不良.
结论：尽管严重三尖瓣返流的介入治疗具有显著的安全性，但右心室功能障碍和肺血流动力学异常是手术成功和临床结局的重要决定因素。完整的血液动力学检查应该是修复前评估的组成部分，尽管预测结果的有效数据有限。
