SURGICAL TREATMENT OF TRICUSPID VALVE PATHOLOGIES. INDICATIONS AND COMPLICATIONS: SYSTEMATIC LITERATURE REVIEW
DOI:
https://doi.org/10.21272/eumj.2026;14(1);67-78Keywords:
tricuspid valve surgery; tricuspid regurgitation; annuloplasty; valve replacement; De Vega technique, transcatheter interventionsAbstract
Tricuspid valve (TV) disease, in particular, tricuspid regurgitation (TR), has historically received less attention than mitral pathologies, often leading to delayed intervention and suboptimal outcomes. With growing evidence of TR’s independent contribution to morbidity and mortality, surgical and transcatheter treatment strategies have rapidly evolved in recent years.
Objective. This systematic review aimed to synthesize modern data on the indications, procedural strategies, outcomes, and complications associated with surgical and transcatheter management of tricuspid valve disease.
Methods. The review was conducted following PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, and Web of Science for studies published between January 1 2020 and May 30 2025. Studies were screened for eligibility based on predefined inclusion and exclusion criteria. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized controlled trials and the ROBINS-I tool for cohort studies. Data were extracted on intervention types, functional outcomes, procedural complications, and patient selection criteria.
Results. Thirty-six studies met inclusion criteria, including 10 systematic reviews. Transcatheter approaches – particularly TriClip, EVOQUE, and LuX-Valve – demonstrated favorable safety and symptom improvement in high-risk populations. Surgical intervention remains the standard for anatomically suitable patients, especially when performed early. Functional gains were consistent across modalities, but long-term durability and recurrence rates varied. Risk of bias was low in the lone randomized controlled trial (RCT) and moderate in most cohort studies.
Conclusions. Surgical and transcatheter treatments for TV disease each offer distinct advantages based on patient selection and disease stage. Continued standardization of outcome reporting and expansion of randomized trials are critical to optimizing care strategies.
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Copyright (c) 2026 Ruslan Mykytenko, Borys Todurov, Gavrylo Kovtun
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