The tricuspid valve and the right heart: anatomical, pathological and imaging specifications

Transcatheter tricuspid valverepair/replacement is an emerging therapy for patients with symptomatic severe tricuspid regurgitation who are deemed inoperable. Accurate knowledge of the anatomy of the tricuspid valveand right ventricleis key to developing transcatheter techniques. In addition, it is important to understand the mechanistic concept of transcatheter tricuspid valverepair/replacement in order to select the patients who may benefit from it. The severity and mechanism of tricuspid regurgitation, right ventricular function, dimensions of the caval veins and the course of the right coronary arteryin relation to the atrioventricular groove are important aspects to be evaluated before embarking on these procedures. The present article reviews current advances in transcatheter approaches for significant tricuspid regurgitation and the role of imaging modalities to characterise the anatomy of the tricuspid valveand right ventricleas well as the underlying pathophysiology of tricuspid regurgitation.