Abstract
Isolated tricuspid regurgitation is the second most common cause of secondary tricuspid insufficiency. It results from tricuspid annulus dilatation leading to malcoaptation in patients without significant left-sided heart disease or pulmonary hypertension.
Isolated tricuspid regurgitation typically occurs in elderly patients with a high prevalence of atrial fibrillation and severe right atrial dilatation; therefore, it is also referred to as atrial tricuspid regurgitation. We present a case of an 85-year-old woman with symptomatic severe isolated tricuspid regurgitation.
Imaging methods (transthoracic and transoesophageal echocardiography, cardiac magnetic resonance imaging) were used to quantify the haemodynamic severity of valvular regurgitation and assess right ventricular function as well as tricuspid annulus morphology. Cardiac catheterization revealed normal coronary angiography and mild postcapillary pulmonary hypertension.
The patient was discussed by the heart team and transcatheter intervention of the tricuspid valve was recommended. Transcatheter edge-to-edge repair was successfully performed resulting in clinical improvement of the patient's symptoms.
Severe isolated tricuspid regurgitation is associated with excess mortality. Tricuspid valve surgery improves survival; however, it carries a significant operative risk.
Transcatheter interventions are a promising option for symptomatic patients with isolated tricuspid regurgitation who are not suitable for surgery.