Tricuspid Regurgitation (TR) is an increasingly recognised condition associated with right-sided chamber dilation, pulmonary hypertension, left-sided valvular disease and atrial fibrillation. Historically underdiagnosed and undertreated, TR is now understood to significantly influence symptoms, hospitalisation rates and long-term outcomes. As new transcatheter therapies emerge, clinicians frequently seek updated guidance on Tricuspid Regurgitation when attending structural-heart and imaging tracks at a cardiology conference. With renewed clinical interest, this session provides a deep exploration of advanced tricuspid-valve disease assessment across diverse patient populations.

The description begins by distinguishing primary from secondary TR, highlighting degenerative leaflet disease, congenital abnormalities, pacemaker-lead interactions and functional dilation as key contributors. Participants examine how right-sided hemodynamics, pulmonary pressures, atrial enlargement and ventricular interactions shape the progression of TR. Symptom patterns such as fatigue, edema, hepatic congestion and ascites are reviewed to support earlier recognition.

Diagnostic strategies rely heavily on echocardiography. The session covers assessment of leaflet anatomy, coaptation defects, right-ventricular size and function, vena contracta measurement, hepatic-vein flow and right-atrial pressure estimation. 3D echo and MRI are explored for enhanced quantification and pre-intervention planning. Attendees also learn how TR severity may be underestimated and the importance of comprehensive right-heart evaluation.

Management principles include optimising heart-failure therapy, controlling volume status, treating pulmonary hypertension and addressing left-sided causes. Surgical and transcatheter options are reviewed, including annuloplasty, leaflet repair systems and edge-to-edge devices. The session highlights patient-selection criteria, anatomical challenges and timing of intervention to prevent irreversible right-ventricular dysfunction.

Emerging technologies, including transcatheter tricuspid-replacement platforms, fusion imaging and AI-enhanced valve analysis, offer new opportunities for improved outcomes. By understanding pathophysiology, diagnostic complexities and evolving treatment pathways, clinicians become better equipped to manage TR in both acute and chronic settings.