The right therapy for right heart failure and tricuspid regurgitation: fixing my patient congestion, not just a valve

Learning Objectives

• To recognise the simplistic nature and limitations of a solely anatomy-based tricuspid treatment algorithm, and the importance of incorporating clinical factors
• To discuss why residual severe tricuspid regurgitation after edge-to-edge repair represents a suboptimal clinical outcome
• To understand why severe right ventricular dysfunction identifies patients at high risk for orthotopic tricuspid replacement
• To identify patient cohort in which heterotopic bicaval valve implantation may provide superior safety, symptomatic and hemodynamic benefit compared to TEER or orthotopic replacement
• To identify when and why leaflet-directed therapies may be insufficient in advanced stages of right heart failure