A standardized stepwise work-up for patients with tricuspid regurgitation provides practical algorithms and structured protocols for clinical, imaging, and invasive evaluation at expert centers.
This review provides a standardized stepwise work-up and practical algorithms for the evaluation and management of patients with tricuspid regurgitation, aligning with the 2025 ESC/EACTS Guidelines.
Abstract Tricuspid regurgitation (TR) is a common yet historically neglected condition associated with poor outcomes. Traditionally managed conservatively, TR has recently gained renewed attention, thanks to advances in surgical and transcatheter interventions. Selecting the optimal therapy, however, requires an integrated and systematic approach considering TR aetiology, stage of the disease, comorbidities, operative risk, and anatomical feasibility. This review describes a standardized stepwise work-up for patients with TR from the referral centre to the expert heart valve centre (HVC). It provides practical algorithms and structured protocols covering clinical and biological assessment, multimodality imaging (echocardiography, computed tomography, cardiac magnetic resonance), and invasive haemodynamic evaluation. The document highlights the importance of multidisciplinary collaboration, involving imagers, heart failure specialists, interventional cardiologists, electrophysiologists, and surgeons, in line with the new recommendations of the 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease. By harmonizing diagnostic standards and promoting a structured approach to patient assessment within HVCs, this review aims to facilitate timely referral and ensure consistent evaluation and management of patients with this complex and often underestimated condition.
“Ce n'est pas la chirurgie elle-même qui est mortelle, mais le statut du patient au moment de l'intervention. Il faut la proposer suffisamment précocement, avant l'atteinte irréversible d'organes tels que le foie ou les reins et l'insuffisance cardiaque réfractaire”
Dreyfus et al. (2026) conducted a review in Tricuspid regurgitation. Standardized stepwise work-up was evaluated. A standardized stepwise work-up for patients with tricuspid regurgitation provides practical algorithms and structured protocols for clinical, imaging, and invasive evaluation at expert centers.