Tricuspid valve defects: What treatment options are there?
Tricuspid valve leakage (also called tricuspid valve insufficiency) is a common heart condition, but it doesn’t always need treatment. When the leakage is more serious, the valve between the right upper and lower chambers of the heart doesn’t close properly. This means that when the heart pumps, some blood flows backward into the upper chamber instead of moving forward to the lungs. As a result, pressure builds up in the veins, which can cause fluid to collect in the belly and legs—similar to what happens when the valve is narrowed (called tricuspid stenosis).
To help manage these symptoms, doctors often prescribe medications called diuretics. These are sometimes known as “water pills” because they help the body get rid of extra fluid by making you urinate more. This can reduce swelling in the legs and belly and also ease shortness of breath.
Expanding a defective tricuspid valve?
So far, only a small number of people have had a procedure called balloon valvuloplasty to treat narrowing of the tricuspid valve. In this treatment, a small balloon is inserted and gently inflated to widen the valve opening. This helps the heart pump more blood into the right lower chamber and reduces pressure in the veins. However, doctors still don’t have enough long-term data on how well this works, and it can sometimes lead to the valve becoming leaky. Because of this, replacing the valve with a biological (tissue) valve is usually preferred. This is because fixing a stiff and narrowed valve is often less successful, and mechanical valves carry a higher risk of blood clots when used in this part of the heart.
Tricuspid valve narrowing often happens along with a leaky tricuspid valve or problems with the mitral valve on the left side of the heart. If a procedure is planned—whether through a catheter or surgery—the tricuspid valve is usually replaced during the same operation.
... or would you rather replace / repair?
If the tricuspid valve is leaking badly, your doctor may recommend either repairing it or replacing it. Repair means fixing the existing valve, while replacement involves putting in a new one. Both options are usually done through open-heart surgery, which means the chest bone (sternum) is carefully opened to reach the heart .
This kind of surgery is a major procedure and carries some risks, especially for older adults, people who are physically weak, or those with other health problems. That’s why your medical team will carefully weigh the benefits and risks before deciding on the best treatment for you.
Please, replace the whole text: Minimally invasive surgery is a gentler option because it avoids cutting through the breastbone. Instead, the tricuspid valve is repaired or replaced through a small opening in the chest. During this procedure, done under general anesthesia, a heart-lung machine temporarily takes over the work of the heart and lungs. If the valve used is made from natural tissue (not mechanical), you usually don’t need to take blood-thinning medication for life. However, these tissue valves can wear out over time and may need to be replaced after about 15 years.
There are also catheter-based options to repair or replace the tricuspid valve or a worn-out tissue valve. One method uses a small clip to bring the valve flaps closer together, helping the valve close more tightly and reducing the backward flow of blood. This is done by guiding a thin tube with the clip through a small cut in the groin up to the heart.
No matter which treatment is chosen, the decision is made by a team of heart specialists. They work closely with you to consider your overall health and personal preferences, aiming to find the best solution for your needs.
- References
- www.mayoclinic.org/diseases-conditions/tricuspid-valve-regurgitation/diagnosis-treatment/drc-20350173
- patient.info/doctor/tricuspid-valve-disease
- jucvm.com/articles/doi/ejcm.galenos.2023.2022-04-028
- my.clevelandclinic.org/health/treatments/23277-valvuloplasty
- www.mayoclinic.org/tests-procedures/tricuspid-valve-repair-tricuspid-valve-replacement/about/pac-20385087
- www.hopkinsmedicine.org/health/treatment-tests-and-therapies/tricuspid-valve-replacement-and-repair
- www.mymichigan.org/conditions-treatments/cardiovascular/specialized-programs/heart-valve-clinic/triclip-procedure/
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