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. 2020 Oct 13;115(4):720–775. [Article in Portuguese] doi: 10.36660/abc.20201047

Table 47. Tricuspid regurgitation: Recommendations1,2,149,151–158.

Intervention Clinical condition SBC AHA ESC
Tricuspid repair with a prosthetic ring

  • Left valvular heart disease intervention and severe TR

 I C I C I C

  • Left valvular heart disease intervention and tricuspid annulus ≥ 40 mm

 IIa C IIa B IIa C

  • Left valvular heart disease intervention, severe TR, and signs of right ventricular dysfunction

 IIa C IIa B IIa C

  • Left valvular heart disease intervention, moderate to severe TR, and/or annulus ≥ 40 mm and SPAP ≥ 70 mmHg

 IIa C IIb C IIa C

  • Severe TR alone, refractory to clinical treatment

 IIa C IIa C IIa C

  • Severe primary asymptomatic TR alone, with right ventricular dilation or progressive dysfunction

 IIb C IIb C IIa C
Surgical valve replacement

  • Repair not possible

 I C I C I C

  • Bioprosthesis preferable

 I B – –
Transcatheter tricuspid valve implantation

  • Refractory to clinical treatment, with contraindication or high surgical risk (currently under study)

 IIb C* – –
*

Consider discussion in the Heart Team. AHA: American Heart Association; ESC: European Society of Cardiology; SBC: Sociedade Brasileira de Cardiologia (Brazilian Society of Cardiology); TR: tricuspid regurgitation.