Julien Dreyfus and Fabien Praz review the current indications and management of severe tricuspid regurgitation, highlighting that treatment is now recommended for symptomatic patients, and emphasising the importance of early referral before irreversible organ damage occurs. They outline a stepwise, multimodality diagnostic approach performed in expert heart valve centres, combining echocardiography, CT, right heart catheterisation and heart team evaluation to guide decision-making. Recent evidence shows that effective reduction of tricuspid regurgitation, whether through repair or replacement, can improve symptoms and reduce heart failure hospitalisations. The key message is that timely diagnosis, appropriate patient selection, and a tailored strategy are essential to optimise outcomes.
