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Chronic Coronary Syndrome — EECC MCQ

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HardCoronary Artery DiseaseChronic Coronary SyndromeEECC

A 69-year-old has torrential secondary tricuspid regurgitation, recurrent right-heart-failure admissions, preserved LV function and moderate RV dysfunction. Pulmonary vascular resistance is 2.2 Wood units and there is no severe pulmonary hypertension. Surgical risk is high. What should the valve team consider?

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Correct answer: E — Transcatheter tricuspid intervention before advanced RV failure develops

Severe symptomatic secondary tricuspid regurgitation should be addressed before irreversible right-ventricular or end-organ failure. In an anatomically suitable patient at high surgical risk and with acceptable pulmonary vascular resistance, transcatheter tricuspid intervention can be considered. Waiting for established severe RV dysfunction loses the treatment window. Mitral edge-to-edge repair targets a normal valve, pulmonary vasodilator monotherapy does not eliminate the tricuspid orifice, and isolated coronary-sinus closure is not an established treatment for torrential tricuspid regurgitation.

Reference: 2025 ESC/EACTS Guidelines for valvular heart disease. https://academic.oup.com/eurheartj/article/46/44/4635/8234488