[TricValve implantation: new catheter intervention in severe tricuspid regurgitation].

Abstract

Severe, symptomatic tricuspid regurgitation is a progressive disease with poor prognosis and limited treatment options. TricValve (bicaval, heterotopic valve system) implantation is a new palliative treatment option. The stented bioprosthesis are implanted in the inferior and superior caval veins without interveniening with the native tricuspid valve. We would like to present the first TricValve implantation in Hungary. The 74-year-old woman was admitted for decompensation after repeted hospitalization for right-sided heart failure due to severe secondary tricuspid regurgitation. On admission, she was in NYHA IV functional class with significant fluid retention. On echocardiogram, left ventricular ejection fraction was preserved with signs of right ventricle volume overload and a non-coapting tricuspid valve regurgitation severe regurgitation. Tricuspid valve replacement was indicated, however, the Heart Team contraindicated any surgeries due to the high risk of mortality. The anatomy of the tricuspid valve was not suitable for percutaneous interventions either, however, the anatomy of the caval veins was suitable for TricValve implantation. The valve implantation underwent in a relatively compensated state without any complications. After cardiac rehabilitation, the patient was in NYHA II functional class, the diuretic need was lowered significantly and in the following year no hospitalisation was needed. TricValve implantation can be a solution for patients with severe tricuspid regurgitation if medical treatment is insufficient and surgical and percutaneous valve repair is contraindicated. The implanted cavals valves reduce the reverse venous flow, therefore congestion and symptoms are reduced. To the best of our knowledge, this new procedure can be an adequate palliative treatment, however, long-term survival data are not available yet. Orv Hetil. 2025; 166(32): 1270–1277.