Step-by-Step Transcatheter Tricuspid Valve Replacement Using the LuX-Valve Plus System

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Device Technology

Background:

• Tricuspid regurgitation (TR) is a significant valvular heart disease often requiring intervention.
• Transcatheter tricuspid valve replacement (TTVR) is an emerging alternative to surgical repair.
• The LuX-Valve Plus is a novel device designed for radial force-independent orthotopic TTVR.

Observation:

• Computed tomography (CT) is crucial for preprocedural assessment and procedural planning.
• Multimodality imaging, including transesophageal echocardiography (TEE), intracardiac echocardiography (ICE), and fluoroscopy, guides device implantation.
• Key procedural steps include right ventricle navigation, leaflet capture, valve adjustment, and septal anchor deployment.

Findings:

• The LuX-Valve Plus demonstrates effectiveness in reducing TR.
• Optimal alignment is achieved using TEE multiplanar reconstruction for delivery system steering.
• 3D TEE and ICE provide critical visualization for leaflet capture, especially in challenging TEE cases.
• Fine adjustment functions allow for optimization of valve deployment and management of paravalvular leaks.

Implications:

• This approach facilitates successful TTVR with a focus on accurate device placement and functional outcomes.
• The described imaging and procedural techniques help mitigate potential implantation pitfalls.
• The LuX-Valve Plus represents a promising advancement in minimally invasive treatment for TR.