Transcatheter Tricuspid Valve Replacement: Current Evidence, Device Landscape, and Future Directions

Transcatheter tricuspid valve interventions have rapidly evolved over the last decade in response to the large, historically undertreated population with severe tricuspid regurgitation (TR). While most early experience focused on leaflet approximation and annuloplasty, orthotopic transcatheter tricuspid valve replacement (TTVR) has emerged as a transformative strategy that can achieve near-complete elimination of TR in anatomies that are suboptimal for repair. This narrative review summarizes the epidemiology and pathophysiology of severe TR, the rationale for valve replacement, contemporary TTVR devices and implantation concepts, available clinical evidence, and remaining challenges and future directions.