Tricuspid Valve-in-Valve and Valve-in-Ring

Tricuspid annuloplasty is universally considered the gold standard for the surgical treatment of tricuspid regurgitation in patients with isolated annular dilatation. Conversely, when the tricuspid valve apparatus is extensively remodeled, surgical tricuspid valve replacement offers a better immediate valve continency. However, both annuloplasty and valve replacement are associated with a non-negligible rate of late failure, and redo surgery is usually limited by an unacceptably high risk of mortality. In this setting, transcatheter tricuspid valve-in-valve and valve-in-ring may represent a valid low-risk alternative that needs further investigation.