Orthotopic Transcatheter Tricuspid Valve Replacement

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Severe tricuspid regurgitation (TR) significantly impacts patient frailty and carries high mortality risk with surgical intervention.
• Functional TR, characterized by annular dilation and large coaptation gaps, is common in affected patients.
• Current treatment options for severe TR are limited, especially for frail patients.

Purpose of the Study:

• To review the current landscape and future potential of transcatheter tricuspid valve replacement (TTVR) for severe tricuspid regurgitation.
• To highlight TTVR as an emerging solution for functional TR with annular dilation.
• To discuss the clinical development status of TTVR devices.

Main Methods:

• Review of existing clinical data and ongoing investigations for TTVR therapies.
• Analysis of patient anatomy typically presenting with functional TR and annular dilation.
• Assessment of the developmental stage of current TTVR devices.

Main Results:

• Transcatheter tricuspid valve replacement (TTVR) is identified as the most suitable approach for the specific anatomy of functional TR.
• Several TTVR devices are in early clinical development, with one progressing to a pivotal trial.
• Promising therapeutic advancements are underway for TTVR.

Conclusions:

• TTVR is poised to become a significant treatment modality for severe tricuspid regurgitation.
• The development of TTVR technologies is expected to improve outcomes and survival for patients with TR.
• Further clinical investigation is crucial to establish the efficacy and safety of TTVR.