Table 46. Step 5: Type of severe tricuspid regurgitation intervention^{149,151–158}.

Type	Considerations
Tricuspid repair with a prosthetic ring	Treatment of choice
	Indications: –Left valvular heart disease intervention in the presence of tricuspid annulus ≥ 40 mm and/or moderate to severe tricuspid regurgitation –tricuspid regurgitation alone, refractory to clinical treatment, low surgical risk, without contraindications.
	Contraindications: severe right ventricular systolic dysfunction
Surgical valve replacement	If repair is possible Bioprosthesis is preferable
Transcatheter tricuspid valve implantation	Refractory symptoms, with contraindication or high surgical risk (currently under study)