Mum's echo says severe tricuspid regurgitation and her ankles are like balloons. Is there a keyhole fix like TAVR for that valve?

#1SueHargreaves(Joined Oct 2026 · 4 posts)October 25, 2026, 12:30 pm

I have been lurking here because of my dad's TAVR two years ago, which went brilliantly. Now it is my mum's turn for heart trouble and it is a different valve so I am lost again.

She is 81, has had a pacemaker for six years and atrial fibrillation for longer. For the last year her ankles and legs have swollen so badly she cannot get her shoes on by the afternoon, and she is exhausted. Her latest echo says "severe tricuspid regurgitation". The cardiologist has doubled her water tablets and mentioned "a referral for consideration of transcatheter options", and then the appointment ran out of time.

Is there a TAVR equivalent for the tricuspid valve? Does the pacemaker wire matter? And why does nobody ever talk about this valve?

#2Ron Castellano(Joined Feb 2026 · 47 posts)October 25, 2026, 6:10 pm

No experience of the tricuspid I'm afraid Sue, but my cardiologist did mention my pacemaker wire goes through it when he was explaining the pacemaker to me. I had no idea there even was a valve there until then.

#3Dr. Helena VossClinical reviewer(Joined Jan 2026 · 58 posts)October 27, 2026, 9:50 am

SueHargreaves said:

Is there a TAVR equivalent for the tricuspid valve?

Sue, the short answer is yes, there are now catheter treatments designed for the tricuspid valve, but they are newer than TAVR, available in fewer centres, and suitable for a narrower group of people, which is presumably what "consideration of transcatheter options" means in your mum's letter. Diane has just written up the basics in tricuspid valve regurgitation, which is worth reading before the referral appointment.

The two main approaches are a clip repair, transcatheter edge-to-edge repair or TEER, which works on the same principle as the mitral clip described in MitraClip explained, and a catheter-delivered replacement valve. In the US, the first of each was approved in 2024 for people who remain symptomatic with severe tricuspid regurgitation despite optimal medicines. The trial evidence for the clip shows a large reduction in leakage and a meaningful improvement in quality of life, but it has not yet shown a difference in survival or hospital admissions, which is worth knowing when weighing it up.

Your instinct about the pacemaker wire is a good one. Leads that cross the tricuspid valve are a recognised cause of leakage, alongside atrial fibrillation and enlargement of the right side of the heart. The lead can also affect which treatment is technically possible, so the team will look at it closely on detailed imaging, usually including a scan through the gullet. Whether your mum is suitable for either approach is for the specialist team who see those images; I cannot tell from a description.

As for why nobody talks about it: for decades there was little to offer beyond medicines, so it attracted less attention. That is changing. In the meantime, the swelling deserves the water tablet review she has had, and if she becomes more breathless, notices rapid weight gain, or feels faint, the cardiology team should hear about it before the referral date.

#4TwoNightsTerry(Joined Feb 2026 · 63 posts)October 28, 2026, 2:20 pm

Sue, write down your questions before the appointment, they always run out of time. Ask about the wire first since that seems to be the big one.

#5SueHargreaves(Joined Oct 2026 · 4 posts)November 2, 2026, 5:05 pm

Thank you, all of this is very helpful. Read Diane's article twice. Mum's referral appointment is at the regional centre at the end of the month and the letter mentions a "TOE", which I now know is the gullet scan. The extra water tablets have brought her ankles down a bit already and she got her own shoes on yesterday, which she was very pleased about.