Transcatheter interventions for tricuspid regurgitation - heterotopic technology: TricValve

Transcatheter Caval Valve Implantation of the Tricento Valve for Tricuspid Regurgitation Using Advanced Intraprocedural Imaging

“…The rationale behind this therapeutic approach is the reduction of hepatic, abdominal, and systemic venous congestion and associated symptoms such as ascites and peripheral edema. Currently, several devices are under clinical investigation: 1) the Sapien 3 (Edwards Lifesciences, Irvine, California) has been used for intracaval implantation, however, it can only be positioned in caval position after preceding stent implantation; 2) the TricValve (P & F Products & Features, Wessling, Germany) is a system with 2 nonidentical self-expandable tissue valves on a nitinol stent positioned in the SVC and IVC ( 2 ); and 3) the Tricento valve is a self-expanding stent with landing zones in the SVC and IVC, and a bicuspid valve opening in the lower atrial segment of the stent ( 3 ). In the largest caval valve cohort (n = 25) ( 4 ), a procedural success rate of 96% with implantation of either the Sapien 3 or the TricValve with a complete reversal of hepatic vein flow in all patients with implants was reported.…”

Interventional treatment of tricuspid regurgitation

“…The procedure is technically simple and can be performed rapidly without interference to cardiac structures. Devices do not interfere with pre-existing pacemaker or defibrillator leads, which might represent a limitation for orthotopic procedures on the tricuspid valve [13]. Particularly with respect to congestion and symptom relief the device may be beneficial in patients without other therapeutic options, while potential mortality benefit data are currently lacking.…”

New Percutaneous Options for Tricuspid Intervention: How to Identify the Good Clinical Candidate

“…As the disease progresses and with increasing leaflet tethering, edge-to-edge devices either alone or in combination with annuloplasty systems for a synergistic effect may be the preferred treatment strategy. If RV function is preserved, then orthotopic valve replacement can also be considered (31), otherwise if RV remodeling is extensive then heterotopic valve implantation is preferred as a palliative strategy in selected cases (32,33).…”