Tricuspid Valve Disease (TVD), including TR and tricuspid stenosis, is estimated to affect >70 million people worldwide.⁵ In Europe, the rate of moderate or greater TR is estimated to be 1.1% in patients aged ≥65 years, and the prevalence increases to 4.0% in patients aged ≥75 years.¹

Moderate-to-severe TR is associated with increased mortality, and the risk of mortality increases with TR severity.^1,6–12 Higher TR severity is independently associated with increased rates of all-cause mortality.^6–12

The tricuspid valve is often referred to as the “forgotten valve”, as TVD was historically perceived to be less important than Left-Sided Heart Disease (LSHD) and was not normally considered for surgical treatment.^13–16 In recent years, there is increasing focus on the tricuspid valve and diseases affecting its function, due to increased awareness and understanding of the adverse consequences associated with TVD.^14,16,17 The tricuspid valve is located between the Right Atrium (RA) and the Right Ventricle,¹³ and controls the flow of blood between these two heart chambers.¹⁸

TR occurs when the tricuspid valve does not close sufficiently during ventricular contraction (systole), and consequently allows blood to flow backwards through the tricuspid valve from the right ventricle into the RA.^19,20 TR places substantial strain on the heart, as the heart must work harder to pump blood into the right ventricle, against the backflow of blood regurgitating through the tricuspid valve.¹⁸

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TR can be classified as primary (e.g. degenerative) or secondary (functional), depending on the underlying cause of the condition, and some patients may present with a mixed aetiology, although this is uncommon.^{1,11,13,15,21} TR is commonly associated with HF, Atrial Fibrillation (AF), pulmonary hypertension, drug use, and cardiac device implantation (e.g. pacemaker leads).^{17, 20,22,23}