Minimally Invasive Valves System Alleviates Severe Tricuspid Insufficiency

A new transcatheter bioprosthesis help those suffering from caval reflux resulting from severe tricuspid regurgitation, without removal of the defective tricuspid valve.

The P&F (Vienna, Austria) TricValve Transcatheter Bicaval Valves System consists of two self-expanding biological valves that are implanted via a percutaneous procedure simultaneously into both the superior and inferior vena cava, and without disturbing the native tricuspid valve. The bioprosthesis valves are available in different diameters, one for the superior vena cava (SVC) and one inferior vena each cava (IVC). The valves, made of bovine pericardium, come fully pre-mounted, facilitating the use of the system in clinical practice.

The SVC valve is available in sizes of 25 mm and 29 mm; the 25 mm valve encompasses a treatment range of 22-31 mm, and the 29 mm valve is intended for veins 27-34 mm in diameter. Nitinol frame heights are 67 and 69 mm respectively in a relaxed state, with a long polyethylene terephthalate (PET) skirt to prevent para valvular leak (PVL). The IVC valve is available is 31 mm and 35 mm diameters; the treatment ranges are 24-31 mm and 28-35 mm, respectively. Frame height in both IVC valves is 65 mm, including a short PET skirt to prevent hepatic vein occlusion.

“TricValve provides a new treatment option for patients that are not suitable for surgery, as well as patients with very dilated annulus or very large coaptation gap, or even with a pacemaker,” said Shaiful Azmi Yahaya, MD, head of the cardiology department at the National Heart Institute (Kuala Lumpur, Malaysia).

The tricuspid valve separates the right atrium of the heart from the right ventricle, preventing blood from flowing from the ventricle back into the atrium. Diseases of the tricuspid valve are much rarer than those of the mitral valve, its counterpart in the left half of the heart. Tricuspid insufficiency leads to the build-up of blood in the ventricle and the veins causes increased pressure on these organs, resulting in water retention in the legs and abdomen, liver damage, and potential atrial fibrillation (AF).

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