When Everything Else Fails: TricValve® in a Dialysis-Dependent Patient with Advanced Right Heart Failure

Area of Science:

• Cardiology
• Interventional Cardiology
• Nephrology

Background:

• End-stage renal disease (ESRD) patients on dialysis often have complex cardiovascular conditions.
• Severe tricuspid regurgitation (TR) significantly impacts right heart function and can complicate management in ESRD patients.
• High-risk ESRD patients with severe TR face limited treatment options due to prohibitive surgical risks.

Purpose of the Study:

• To report the first European case of TricValve® system implantation in a dialysis-dependent patient with severe TR.
• To evaluate the feasibility and therapeutic value of percutaneous caval valve implantation in a high-risk ESRD patient.

Main Methods:

• A 72-year-old male ESRD patient with severe TR, hypotension, and cardiogenic shock underwent urgent percutaneous caval valve implantation with the TricValve® system.
• Transcatheter edge-to-edge repair was considered unsuitable due to extensive annular dilation.

Main Results:

• The TricValve® procedure was technically successful, achieving immediate hemodynamic stabilization.
• The patient experienced improved tolerance of renal replacement therapy and rapid clinical recovery.
• Follow-up imaging confirmed optimal device placement without complications.

Conclusions:

• Percutaneous caval valve implantation with the TricValve® system is a feasible and effective treatment for carefully selected, high-risk dialysis-dependent patients with severe TR.
• This minimally invasive approach offers a therapeutic alternative when traditional surgical or transcatheter options are not viable.