Significant functional tricuspid regurgitation (FTR) represents a poor prognostic factor independent of right ventricular (RV) function. It is usually the consequence of left-sided cardiac diseases that induce RV dilatation and dysfunction, but it can also resulted from right atrial (RA) enlargement and consequent tricuspid annular dilatation. FTR is very frequent among patients with heart failure, particularly in those with reduced LVEF and concomitant functional mitral regurgitation. The development of three-dimensional echocardiography enabled detailed assessment of tricuspid valve anatomy, subvavlular apparatus, and RA and RV changes, as well as accurate evaluation of FTR etiology. Due to high in-hospital mortality risk in patients who were operatively treated for isolated FTR, it has been treated only medically for a long time. Percutaneous approach considers mainly transcatheter tricuspid valve repair (edge-to-edge and annuloplasty) and represents a very attractive option for the high-risk patients. Studies that investigated the effects of different devices showed excellent feasibility and safety, followed by significant reduction in FTR grade, improvement in functional capacity and NYHA class, quality of life, and reduction in hospitalization due to heart failure. Some investigations also reported a decreased mortality in FTR patients. Nevertheless, the results of these investigations should be interpreted with cautious due to the small number of participants and relatively short follow-up. The aim of this review was to summarize the existing data about the clinical importance of FTR and FTR-induced right heart remodeling and currently existing therapeutic approaches for treatment of FTR.

显着的功能性三尖瓣反流 (FTR) 是独立于右心室 (RV) 功能的不良预后因素。这通常是左心疾病导致右心室扩张和功能障碍的结果，但也可能是右心房 (RA) 扩大和随之而来的三尖瓣环扩张的结果。FTR 在心力衰竭患者中非常常见，特别是在 LVEF 降低并伴有功能性二尖瓣关闭不全的患者中。三维超声心动图的发展使得能够详细评估三尖瓣解剖、瓣膜下装置以及 RA 和 RV 变化，以及准确评估 FTR 病因。由于孤立性 FTR 手术治疗的患者院内死亡风险高，长期以来一直只接受药物治疗。经皮入路主要考虑经导管三尖瓣修复（边缘到边缘和瓣环成形术），对于高危患者来说是一种非常有吸引力的选择。调查不同设备效果的研究显示了出色的可行性和安全性，随后 FTR 等级显着降低，功能能力和 NYHA 等级、生活质量和因心力衰竭住院减少。一些调查还报告了 FTR 患者的死亡率降低。然而，由于参与者人数少且随访时间相对较短，因此应谨慎解释这些调查的结果。