Tricuspid valve intervention shows varying survival benefits depending on the underlying cause of regurgitation. Findings from the international TRIGISTRY cohort were presented at the European Society of Cardiology Congress 2025. The study shows that the underlying cause of tricuspid regurgitation (TR) influences the benefit of intervention. The analysis compared tricuspid valve intervention versus conservative management across 1,552 patients with severe functional TR and a low-to-intermediate TRI-SCORE (≤5).
Patients were classified into three groups: isolated TR (ITR), TR after prior left-heart intervention (LHI-TR), and undetermined TR (UTR). About half of the patients underwent an intervention, either surgical or transcatheter, while the rest were managed conservatively.

Those with ITR were generally healthier, with fewer comorbidities, while UTR patients carried the highest clinical burden. Survival analysis showed a clear benefit of intervention in ITR, with survival gains persisting after adjusting for comorbidities and TRI-SCORE. Patients with UTR also experienced modest benefit, though smaller in magnitude. In contrast, those with LHI-TR showed no significant difference between intervention and conservative management.

These results suggest that the value of tricuspid valve intervention is not uniform across all patient groups. Instead, the etiology of TR appears to play a defining role in determining who may gain the most survival benefit.

The TRIGISTRY investigators emphasized that while the findings are compelling, unmeasured confounders may still influence outcomes. Larger studies and randomized trials will be essential to refine patient selection strategies and identify subsets most likely to benefit from tricuspid valve intervention.