Evaluation and Management of Tricuspid Regurgitation

Clinicians should include specific measurements during echocardiograms to accurately assess tricuspid regurgitation and related factors. These measurements include the area of the right atrium, basal diameter of the right ventricle, tricuspid annular plane systolic excursion (TAPSE), and fractional area change. It is important to utilize the right ventricular apical view to obtain valid measurements. Referral to a tertiary center is recommended for patients with paroxysmal or persistent atrial fibrillation, moderate or severe tricuspid regurgitation, and signs of right heart failure. Aggressively targeting sinus rhythm in these patients can potentially lead to favorable remodeling of right atrial structures and regression of tricuspid regurgitation. Surgical repair, including annuloplasty, is the standard of care for good surgical candidates, while transcatheter options may be considered for high-risk patients.