{"id":9141,"date":"2025-11-03T11:44:07","date_gmt":"2025-11-03T08:44:07","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9141"},"modified":"2025-11-03T11:44:07","modified_gmt":"2025-11-03T08:44:07","slug":"acc-2025-expert-pathway-practical-use-of-therapies-in-severe-tricuspid-regurgitation","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/acc-2025-expert-pathway-practical-use-of-therapies-in-severe-tricuspid-regurgitation\/","title":{"rendered":"ACC 2025 Expert Pathway \u2013 Practical Use of Therapies in Severe Tricuspid Regurgitation\u00a0"},"content":{"rendered":"<div>ACC 2025 Expert Pathway \u2013 Practical Use of Therapies in Severe Tricuspid Regurgitation<\/div>\n<div><\/div>\n<div>(Highlighted in a medical news release in October 2025)<\/div>\n<div><\/div>\n<div>Keynotes :<\/div>\n<div><span> 1. Refer early to a valve team when TR is severe + symptomatic (or RV dilation\/dysfunction is progressing), and after optimizing diuretics, AF control, and pulmonary HTN contributors.<\/span><\/div>\n<div><span> 2. T-TEER (e.g., TriClip) if functional\/secondary TR with favourable leaflet anatomy (adequate tissue, manageable coaptation gap\/tethering), preserved\/moderately reduced RV, and no pacing lead prohibiting grasping.<\/span><\/div>\n<div><span> 3. TTVR (e.g., Evoque) if TEER-unsuitable anatomy (very large gap, severe tethering\/multiple jets), torrential TR, lead-related TR where replacement is preferable, or failed prior TEER\u2014provided RV function and pulmonary vascular resistance are acceptable and anticoagulation is feasible.<\/span><\/div>\n<div><span> 4. Surgery when concomitant left-sided surgery is planned, or primary\/organic TR (leaflet pathology, endocarditis, trauma\/Ebstein) in younger\/low-risk patients where durable repair is likely.<\/span><\/div>\n<div><span> 5. Defer\/avoid intervention with end-stage RV failure, severe, fixed pulmonary HTN, advanced multi-organ dysfunction, frailty\/limited life expectancy, or anatomy unsuitable for both TEER\/TTVR.<\/span><\/div>\n<div><span> 6. Imaging for selection: baseline TTE\/TEE for mechanism\/severity; CT (landing zone\/annulus, leads, RV\u2013PA geometry) especially for TTVR; CMR if RV size\/function is uncertain.<\/span><\/div>\n<div><span> 7. Post-procedure care: diuretic optimization, rhythm management, RV monitoring; anticoagulation after TTVR per device\/protocol and bleeding risk(anticoagulation after TTVR = usually oral anticoagulant such as warfarin or DOAC for \u22483\u20136 months, adjusted to bleeding risk and device protocol.) ; scheduled echo follow-up(at discharge, 1\u20133 months, and periodically thereafter).<\/span><\/div>\n<div><\/div>\n<div><a href=\"https:\/\/www.acc.org\/Latest-in-Cardiology\/Journal-Scans\/2025\/09\/22\/14\/06\/ACC-Releases-ECDP-on-TR-Evaluation-and-Management?utm_source=chatgpt.com\">https:\/\/www.acc.org\/Latest-in-Cardiology\/Journal-Scans\/2025\/09\/22\/14\/06\/ACC-Releases-ECDP-on-TR-Evaluation-and-Management?utm_source=chatgpt.com<\/a><\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>ACC 2025 Expert Pathway \u2013 Practical Use of Therapies in Severe Tricuspid Regurgitation (Highlighted in a medical news release in October 2025) Keynotes : 1. Refer early to a valve team when TR is severe + symptomatic (or RV dilation\/dysfunction is progressing), and after optimizing diuretics, AF control, and pulmonary HTN contributors. 2. T-TEER (e.g., [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9141","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9141","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=9141"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9141\/revisions"}],"predecessor-version":[{"id":9142,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9141\/revisions\/9142"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9141"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9141"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}