Treatment

Treatment for tricuspid valve regurgitation depends on the cause and severity of your condition. The goal of treatment is to reduce your symptoms, avoid future complications and live longer.

If an underlying condition such as heart failure or endocarditis is causing your tricuspid valve regurgitation, your doctors will treat that condition.

Your treatment may include:

Regular monitoring

If you have mild tricuspid valve regurgitation, you may only need to have regular follow-up appointments with your doctor to monitor your condition.

Medications

Your doctor may prescribe medications to treat underlying conditions, such as drugs that prevent water retention (diuretics) and other medications for people with heart failure or medications to help control your heart rate if you have a heart rhythm disorder (arrhythmia).

Surgery

Your doctor may recommend surgery to repair or replace the tricuspid valve if you have severe tricuspid valve regurgitation and you're experiencing signs or symptoms, or if your heart begins to enlarge and heart function begins to decrease. In some cases, your doctor may recommend surgery for severe tricuspid valve regurgitation even if you don't have symptoms but your heart is enlarging. Your doctor will evaluate you and determine if you're a candidate for heart valve repair or replacement.

If you have tricuspid valve regurgitation and you're having heart surgery to treat other heart conditions, such as mitral valve surgery, your doctor may recommend that you have tricuspid valve surgery at the same time.

Surgical options include:

• Heart valve repair. Surgeons try to repair the heart valve instead of replacing it whenever possible. Your surgeon may perform valve repair by separating tethered valve leaflets, closing holes in leaflets, or reshaping the valve leaflets so that they can make contact with each other and prevent backward flow. Surgeons may often tighten or reinforce the ring around a valve (annulus) by implanting an artificial ring.

  Some surgeons perform cone repair, a newer form of tricuspid valve repair, to repair tricuspid valves in people with Ebstein's anomaly. In the cone reconstruction, surgeons separate the leaflets of the tricuspid valve from the underlying heart muscle. The leaflets are then rotated and reattached, creating a "leaflet cone."

Repair leaves you with your own functioning tissue, which is resistant to infection and doesn't require blood-thinning medication, and optimizes function of the right ventricle.

• Heart valve replacement. If your tricuspid valve can't be repaired, your surgeon may perform tricuspid valve replacement. In tricuspid valve replacement, your surgeon removes the damaged valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).

  Biological tissue valves degenerate over time, and often eventually need to be replaced.

  Mechanical valves are used less often to replace tricuspid valves than to replace mitral or aortic valves. If you have a mechanical valve, you'll need to take blood-thinning medications for life to prevent blood clots. Your doctor can discuss the risks and benefits of each type of heart valve with you and discuss which valve may be appropriate for you.

• Catheter procedure. In some cases, if your biological tissue valve replacement is no longer working, doctors may conduct a catheter procedure to replace the valve. In this procedure, doctors insert a catheter with a balloon at the end into a blood vessel in your neck or leg and thread it to the heart using imaging. A replacement valve is inserted through the catheter and guided to the heart.

  Doctors then inflate the balloon in the biological tissue valve in the heart, and place the replacement valve inside the valve that is no longer working properly. The new valve is then expanded.

Maze procedure

If you have fast heart rhythms, your surgeon may perform the maze procedure during valve repair or replacement to correct the fast heart rhythms. In this procedure, a surgeon makes small incisions in the upper chambers of your heart to create a pattern or maze of scar tissue.

Because scar tissue doesn't conduct electricity, it interferes with stray electrical impulses that cause some types of fast heart rhythms. Extreme cold (cryotherapy) or radiofrequency energy also may be used to create the scars.

Catheter ablation

If you have fast or abnormal heart rhythms, your doctor may perform catheter ablation. In this procedure, your doctor threads one or more catheters through your blood vessels to your heart. Electrodes at the catheter tips can use heat, extreme cold or radiofrequency energy to damage (ablate) a small spot of heart tissue and create an electrical block along the pathway that's causing your arrhythmia.