How should I treat a torrential tricuspid valve regurgitation with large coaptation gap size and severe tethered leaflets?

This case has been accredited by EBAC with 1 CME credit

Case available in German

An 84-year-old female patient with severe tricuspid valve regurgitation (TR) and progressive right-sided heart failure signs is referred for diagnosis and treatment. Transoesophageal echocardiography (TEE) reveals isolated torrential TR (5/5) with a large coaptation gap size and tethered leaflets. How would you treat this patient?

EBAC