Percutaneous tricuspid valve replacement: Orthotopic and heterotopic valves

The tricuspid valve has long been described as the “forgotten valve”, leaving tricuspid valve disease relatively neglected. However, the number of people in the United States affected by severe tricuspid regurgitation is growing. Isolated surgery for severe tricuspid regurgitation in the setting of right ventricular heart failure carries a high mortality risk, and therefore, attention to corrective therapies has increased. Because of the different etiologies for tricuspid regurgitation, multiple percutaneous transcatheter options for tricuspid valve repair for severe regurgitation are being studied and have been developed, including annuloplasty systems, leaflet and coaptation devices, vena caval (heterotopic) valve implantations, and tricuspid valve (orthotopic) replacement. In this paper, we review the heterotopic and orthotopic tricuspid valve transcatheter options for severe tricuspid regurgitation.