Transcatheter Tricuspid Valve Interventions for Tricuspid Regurgitation: A Review of Percutaneous Annuloplasty, Edge-to-Edge Repair, and Valve Replacement Devices.

More than 1.6 million people in the United States are affected by tricuspid regurgitation each year; however, definitive treatment options have often been limited due to the high rates of morbidity and mortality associated with isolated tricuspid valve surgery. The year 2024 marked a milestone for percutaneous tricuspid valve interventions, with the Food and Drug Administration approving the EVOQUE valve for transcatheter tricuspid valve replacement and the TriClip for transcatheter edge-to-edge repair. The TriClip and EVOQUE valve, along with the previous Conformité Européene-marked Cardioband and PASCAL devices, have greatly expanded our understanding of the key principles of transcatheter tricuspid interventions that will help shape the next generation of devices. As an integral member of the multidisciplinary heart valve team, the cardiac anesthesiologist plays a critical role in the perioperative care of patients undergoing transcatheter tricuspid interventions. Many patients undergoing transcatheter therapies are older or high risk, so the cardiac anesthesiologist is uniquely positioned to assist with perioperative optimization. A thorough understanding of the unique anesthetic considerations, factors influencing procedural success, and potential complications of these devices is essential to optimize patient outcomes. All four devices are reviewed in detail, including their indications, performance in clinical trials, intraprocedural imaging guidance, and current limitations in transcatheter tricuspid therapies that future investigational devices should aim to address.