The pivotal role of tricuspid regurgitation in the failing systemic right ventricle: The "chicken and egg story".

Systemic right ventricle (SRV) is commonly encountered in patients with congenital heart disease. This nomenclature includes diseases with different anatomic features, adaptation and clinical phenotypes, and has a variable - but overall guarded - prognosis. Right ventricular fibromuscular architecture, shape, adaptation to overload conditions, rhythmic disorders and - most of all - tricuspid regurgitation (TR) contribute to the pathophysiology of SRV failure.

Percutaneous edge-to-edge repair in congenital heart disease: Preliminary results of a promising new technique.

Percutaneous edge-to-edge repair has become a valid technique for symptomatic mitral and tricuspid regurgitation in patients with acquired cardiopathies deemed ineligible for surgery. In congenital heart disease (CHD) and more specifically in systemic right ventricle atrioventricular valve regurgitation, it has a pivotal role in the disease course, functional prognosis, systemic ventricular function, and mortality. While medical therapy is not unequivocally effective, surgery (valve repair or replacement) involves discrepant long-term results that depend mainly on pre-operative systemic ventricular function; it can be too risky for patients who have undergone previous open-heart surgery and have other comorbidities.