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Understanding tricuspid regurgitation

If you or a loved one has symptomatic severe tricuspid regurgitation (TR),  please know that you’re not alone and you do have options when it comes to treatment.

Ed in heart

What is Tricuspid Regurgitation (TR)?

Your heart has four chambers and four valves that open and close to keep blood flowing in the right direction.1 The tricuspid valve separates the upper and lower chambers on the right side of your heart. When your tricuspid valve is working properly, it helps you stay healthy and active.2

tr valve
normal valve
Tricuspid regurgitation happens when the tricuspid valve in your heart doesn't close properly. This causes blood to flow backward instead of forward, making it hard for your heart to pump enough blood to your body. It can make you feel tired and shortness of breath, and if it's not treated, it could lead to other complications like heart failure.1

Over 1.5 million  people in the United States

are estimated to have moderate or greater TR3, 4, 5

Symptoms and signs of severe tricuspid regurgitation may include:

  • Shortness of breath
  • Fatigue
  • Stomach swelling (ascites)
  • Weight gain
  • Jugular vein distension
  • Stomach pain
  • Enlarged liver or spleen
  • Swollen ankles and feet (lower limb edema)
Symptoms chart

Severe TR symptoms often lead to a substantial decrease in your quality of life. Activities like taking walks or just moving from room to room can become extremely challenging and limit your independence. Signs and symptoms of severe TR may be mistaken as normal consequences of aging, which can delay treatment.7, 8, 9

What causes tricuspid regurgitation?

The most common cause of tricuspid regurgitation is the enlargement of the right ventricle. The right ventricle normally pumps blood to the lungs where it picks up oxygen. Conditions that put extra strain on the right ventricle can cause it to enlarge.6 This results in a misshapen tricuspid valve that does not close properly and causes blood to flow back into the right atrium instead of being pumped forward into the lungs.

Most common causes:8

  • Heart failure
  • Pulmonary hypertension
  • Cardiomyopathy

TR can also develop due to:7

  • Infection, such as infective endocarditis or rheumatic fever
  • Congenital heart disease, such as Ebstein anomaly
  • Carcinoid syndrome
  • Endomyocardial biopsy
  • Chest trauma
  • Radiation therapy
  • Injury caused during the placement or removal of implantable device

What happens if your TR is left untreated?

If you have severe tricuspid regurgitation that isn't getting better with medication, the outlook may not be good without additional care.7 Waiting to get help can make your symptoms worse, limit what you can do every day, and increase the risk of heart failure or even death. If you or someone you care about has ongoing symptoms, talk to your cardiologist about tricuspid regurgitation and check out the treatment options available now.

Patient couple

What are your treatment options?

In the past, treatment options for symptomatic severe tricuspid regurgitation were limited to oral medication and heart surgery. However, a minimally invasive treatment is available. This option for treating tricuspid regurgitation can improve quality of life and offer faster recovery than traditional surgery with lasting relief.10

Treatment Options

We’re here for you

Whether you’re looking to learn more about your condition, explore treatment options, or speak with someone who understands, we’re here to help. Our resources provide the information and support you need to make the best decisions for your health. You don’t have to face this alone—reach out today.

My resources

When your tricuspid regurgitation advances, it can be serious. Stay informed and take action.

Contact Edwards' Patient Support Center now for more information about tricuspid regurgitation and the procedure.

Phone:  949-250-2012

Toll free: 888-713-1564

patient_support@edwards.com 

References

  1. American Heart Association. Heart Valves and Circulation. www.heart.org/en/health-topics/heart-valve-problems-and-disease/about-heart-valves/heart-valves-and-circulation. Accessed June 13, 2024.
  2. American Heart Association. Roles of Your Four Heart Valves. www.heart.org/en/health-topics/heart-valve-problems-and-disease/about-heart-valves/roles-of-your-four-heart-valves. Accessed June 13, 2024.
  3. Topilsky Y, et al. Clinical Outcome of Isolated Tricuspid Regurgitation. J Am Coll Cardiol Img. 2014;7:1185-1194.
  4. U.S. Census Bureau (2021). American Community Survey 1-year Estimates.
  5. Cahill TJ, et al. Community prevalence, mechanisms and outcome of mitral or tricuspid regurgitation. Heart. 2021;107:1003-1009.
  6. MedlinePlus; Tricuspid regurgitation. https://medlineplus.gov/ency/article/000169.htm.  Accessed on 2.10.2025.
  7. Welle GA, et al. New Approaches to Assessment and Management of Tricuspid Regurgitation Before Intervention. JACC: Cardiovascular Interventions 2024;17: 837–58.
  8. CardioSmart American College of Cardiology.  Treatment  https://www.cardiosmart.org/topics/tricuspid-regurgitation/treatment Accessed on 2.10.2025
  9. Stocker TJ, et al. Burden of heart failure in patients with tricuspid regurgitation and effect of transcatheter repair on different subdimensions of quality of life. J Am Heart Assoc. 2024;13:e034112.
  10. Hahn RT. Tricuspid      Regurgitation. N Engl J Med. 2023;388:1876-1891.
Important risk information

Important risk information

Edwards EVOQUE Tricuspid Valve Replacement System



Who can be treated:

The EVOQUE tricuspid valve replacement system (the EVOQUE system) is  approved for treating patients with symptomatic severe tricuspid  regurgitation (TR) for the improvement of health status. TR is a  condition in which the tricuspid valve on the right side of the heart  doesn't close properly.  When the valve does not fully close, blood  flows backward from the lower chamber (ventricle) into the upper chamber (atrium) making the patient's heart work harder to move blood through  the valve.  Patients should work with their doctor and a specialized  Heart Team to determine if the patient is a suitable candidate for the  EVOQUE valve.


Who should not use:

The EVOQUE system should not be used in patients who:

  • Cannot take blood thinning medications
  • Have an active infection in the heart or elsewhere
  • Have an untreatable allergy to nickel or titanium

If used in the patients mentioned above, it will not work properly and could make you feel sick or even cause death.


Warnings:

How long your tissue valve will last depends on many patient factors and  medical conditions. Follow all care instructions to ensure the best  possible results. The Edwards EVOQUE valves have been tested in a  laboratory to mimic 5 years of use without failure. Regular follow-ups  will help your doctor know how your EVOQUE valve is working.

  • Follow all care instructions to ensure the best possible results.  Regular follow-up is advised to evaluate the performance of your device
  • Blood thinning medication may be necessary after valve replacement with the EVOQUE system.  Your doctor should prescribe this and other medical therapy per standard guidelines.


The safety and effectiveness of the transcatheter heart valve is not known for patients:

  • Who are dependent on their pacemaker without other pacing options
  • Who had a pacemaker implanted within the last 3 months before the valve implantation procedure
  • Who have severe pulmonary hypertension not managed by medication
  • Who have severe right ventricular dysfunction



Precautions:

Precautions Prior to Use

Seeing a specialized doctor on a Heart Team will ensure you are evaluated for  all treatment options. They will consider factors about your health to  decide the most appropriate treatment option for you.

Your doctor will consider these factors:

  • Your medical history
  • Your age
  • Your current health status
  • Your ability to undergo the procedure and recover from it
  • The overall condition of your heart


General Precautions

  • Problems with the electrical pathway of your heart that require a  pacemaker may occur before, during, or following implantation of the  EVOQUE valve
  • Talk to your doctor about risk of infection and  needing antibiotics if you require a dental procedure after your heart  valve replacement
  • Long-term durability has not been established for the EVOQUE valve. Clinical data is reflective of short-term  follow-up, and regular medical follow-up is advised


Potential Risks

As with any medical procedure, there is a possibility of risks.

The most serious risks associated with the procedure are:

  • Death
  • Stroke
  • Serious bleeding (with the potential to be given blood)
  • Problems with the electrical pathway of your heart that requires a pacemaker
  • Unplanned repeat procedure, hospitalization, or surgery
  • Major vascular complications
  • Permanent disability


Additional potential risks include:

  • Abnormal lab values
  • Abnormal low or high blood pressure
  • Additional cardiac surgery, vascular surgery, or intervention, including removal of the transcatheter heart valve
  • Allergic reaction
  • Anemia
  • Blood leak around the valve
  • Chest pain
  • Collection of fluid or blood around your heart
  • Damage to blood cells
  • Damage to the swallowing passage (esophagus), with possible puncture or narrowing
  • Damage to the valve or deterioration (wear, tear, fracture, leaflet  thickening, stenosis), malposition, clotting, movement or embolization  of the valve, which might require removal of the valve
  • Failure to retrieve any EVOQUE system components
  • Fluid buildup in your lungs
  • Having an abnormal particle (air or blood clots) floating in the bloodstream or attached to an object, including the valve
  • Heart attack or heart failure/decreased heart pumping
  • Incorrect position of valve or valve movement
  • Infection in your heart, blood, or other areas
  • Interference/damage with an existing permanent pacemaker or defibrillator
  • Irregular heart rate
  • Kidney failure
  • Nausea and/or vomiting
  • Nerve injury, paralysis or neurological symptoms, including problems with movement or walking
  • Organ failure, including heart failure
  • Pain, inflammation, or fever
  • Right ventricular outflow tract (RVOT) obstruction
  • Severe bleeding or fluid in or around the heart or in the body that could require a transfusion or surgery
  • Skin burn, injury or tissue changes due to exposure to X-rays
  • Sudden or unexpected loss of heart function
  • Swelling
  • Trouble or inability to breathe
  • Valve regurgitation (new or worsening tricuspid, aortic, mitral, or pulmonary)


CAUTION: Federal (United States) law restricts this device to sale by or on the order of a physician.