One in four patients undergoing isolated tricuspid valve intervention (TVI) experienced poor outcomes despite achieving procedural success. This finding underscores the need for refined patient selection as treatment options for severe tricuspid regurgitation expand. The results were presented at the European Society of Cardiology (ESC) Congress 2025.

The study included 546 patients with severe tricuspid regurgitation. The average age was 72 years, and 69% were women. Most patients (72%) underwent percutaneous intervention. Although two-thirds of patients had no more than moderate residual regurgitation, 25% still met futility criteria within one year.

The Fu-TRI-L score predicts futility in tricuspid valve interventions. Multivariate analysis identified seven predictors: high comorbidity burden (Charlson index ≥3), frailty or dependency, cardiac implantable device–related TR, prior heart failure admissions or severe right-sided symptoms, pulmonary hypertension, and elevated hepatic enzymes. 

The model demonstrated good accuracy with an area under the curve of 0.75. A score ≥8 predicted futility with 65% positive predictive value and 81% negative predictive value. The Fu-TRI-L score may help guide treatment decisions in patients with severe TR.