Moderate-to-severe tricuspid regurgitation (TR) is common and is associated with a poor prognosis. To date, most patients are undertreated; therefore, transcatheter options could be clinically impactful in those who are denied surgery. Several transcatheter solutions have been developed that address the problem via leaflet enhancement, annuloplasty, or heterotopic implantation of self-expandable or balloon-expandable valves in the caval veins. A comprehensive patient evaluation, based on multimodality imaging techniques for a better understanding of the valvular pathology and TR mechanism, remains paramount for an appropriate device selection. To date, several trials have shown the feasibility and safety of a multitude of devices in this setting, but data from randomized clinical trials regarding clinical benefit based on hard endpoints are still lacking. Although the optimal patient profile and timing of intervention remain under investigation, data from available studies indicate that an earlier treatment referral, before onset of irreversible right ventricular remodeling, could be beneficial. This review discusses the present landscape and future implications of transcatheter therapies for severe TR.

中至重度三尖瓣关闭不全（TR）很常见，并且预后不良。迄今为止，大多数患者的治疗不足。因此，经导管的选择对那些拒绝手术的人可能具有临床影响。已经开发了几种经导管的解决方案，这些解决方案通过小叶增强，瓣环成形术或在腔静脉中自扩张或球囊扩张的瓣膜的异位植入来解决该问题。为了更好地了解瓣膜病理学和TR机制，基于多模式成像技术的全面患者评估对于选择合适的设备仍然至关重要。迄今为止，多项试验表明，在这种情况下，多种设备的可行性和安全性，但仍缺乏来自基于硬性终点的临床获益的随机临床试验数据。尽管仍在研究最佳患者概况和干预时机，但现有研究数据表明，在不可逆性右心室重塑发作之前更早转诊可能是有益的。这篇综述讨论了经导管治疗对严重TR的现状和未来意义。