Navigating isolated tricuspid regurgitation: A practical guide to perioperative and periprocedural management
Bibliographic record
Abstract
Isolated tricuspid regurgitation (TR), often called the forgotten valve, defined as regurgitation occurring in the absence of left-sided heart disease, pulmonary hypertension (PH), or organic/congenital leaflet abnormalities, has recently emerged as a condition of growing clinical interest due to its increasing prevalence and its significant, independent association with adverse long-term cardiovascular outcomes. 1,2No institutional review board review was required for this study.The subject(s) provided written informed consent for the publication of the study data.This renewed attention reflects a paradigm shift in the understanding of TR, highlighting its historical underestimation and therefore suboptimal management.Contributing factors include the limited availability of outcome-based data and the lack of effective and timely therapeutic strategies. 2 Historically, isolated TR has been managed conservatively, primarily with diuretic therapy and routine surveillance, largely due to the high in-hospital mortality associated with surgical intervention. [3][4]4][5][6] Consequently, surgery has been typically reserved for symptomatic patients at advanced stages of disease progression. 7,8This conservative approach has recently been called into question, with growing debate over the optimal timing and modality of intervention.In this evolving context, the introduction of refined risk stratification tools 9,10 and the development of transcatheter therapies 11,12 have paved the way to more effective and earlier treatments.However, robust data from prospective studies are still needed to validate the safety and efficacy of these emerging options.This review aims to provide a comprehensive overview of the periprocedural management of isolated TR, addressing patient selection, timing of intervention, and postoperative care.It is presented as an expert narrative synthesis, based on a comprehensive, nonsystematic appraisal of current evidence and informed by multidisciplinary clinical experience to support decision making in routine practice (Figure 1). PREOPERATIVE CONSIDERATIONS Epidemiology and ClassificationAlthough often diagnosed incidentally during routine transthoracic echocardiography, isolated TR is more
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".