EuroPCR

TricValve –
Addressing the Unmet Need for Patients with Right HF and Functional Tricuspid Regurgitation: Real-life Clinical Outcomes

Wednesday May 18th 2022
TricValve –
Addressing the Unmet Need for Patients with Right HF and Functional Tricuspid Regurgitation: Real-life Clinical Outcomes

Our session at EuroPCR addressed the problems of tricuspid regurgitation and focused upon the real clinical needs for patients and improvements in health outcomes.

Hear from the experts

M Haude
J Hausleiter
R Puri
L Rosseel
K Kiss

Concluding remark

Prof. Haude concluded the session with a key take-home message: “TricValve interventions is a new treatment option for patients with severe TR deemed high-risk for surgery. From the early clinical experiences in TRICUS and TRICUS EURO we see that TR patients show improvement on NYHA class, 6MWT, quality of life and reduction in RA, RV up to 1-year follow-up. The TRICAV RCT is intended to confirm these beneficial results in a larger patient cohort and we are eager to await the results of that trial.”

Learning Objectives

  • To learn about the latest treatment option for patients with severe Tricuspid Regurgitation
  • To explore the supporting clinical evidence of TricValve
  • To understand how the TricValve Transcatheter Bicaval Valves system can improve the quality of life for patients

Case summary

An 82-year-old male patient with dyspnea on exertion, presented with NYHA III, walking distance <100m due to torrential TR (grade 5+). He underwent CABG and LAA resection in 2009, having cardio-renal syndrome, cardio-hepatic syndrome, chronic AF, arterial hypertension and hypercholesterolemia with a TriScore of 6 points, predicting a 22% risk of in-hospital mortality, rendering him unsuitable for surgery. Right heart catheterisation showed a mean v-wave of 15mmHg, moderate post cap. pulmonary hypertension. Patient had very dilated right ventricle and significant jet into the RA. The posterior and septal leaflet had a large coaptation gap of >8mm, which rendered it unsuitable for edge-to-edge repair and due to the large annulus size it was also unsuitable for orthotopic valve replacement. Dr J. Hausleiter’s only choice was to implant the TricValve, as this does not touch the native valve at all.
Both self-expanding valves were successfully implanted at the SVC and IVC, respectively. Post procedure pullback from RA to the IVC showed a significant reduction of v-wave pressure, corresponding to the cessation of regurgitation to the IVC and hepatic veins. Echocardiogram showed almost no back flow into the RA.
This is a successful case showing the indication of TricValve in a patient with dilated annulus and large coaptation gap and at risk of open heart surgery.