When a tricuspid regurgitation patient is referred for tricuspid valve treatment, they are typically at the end of their disease process. We need a paradigm shift to treating patients earlier, agreed Dr. Chris Meduri from Piedmont Heart, Dr. Paul Sorajja from Minneapolis Heart Institute and Dr. Gorav Ailawadi from the University of Virginia. The Napa Valley Cardiology Conference presenters discuss the future of the nascent tricuspid space and how to tackle the challenges.