First Performance of Transjugular Transcatheter Tricuspid Valve Replacement with the Lux-Valve Plus System in Latin America. A Case Report

Introduction

The prevalence of tricuspid regurgitation (TR) increases with age, concomitant left-side heart disease, and chronic atrial fibrillation. Moderate or severe TR is associated with excess mortality and poor outcomes. The interventional treatment of choice is tricuspid valve repair, with a prosthetic ring capable of reducing the tricuspid annulus diameter, improving valve leaflet coaptation, and correcting regurgitation. Valve replacement is reserved for patients who do not have anatomical conditions for repair. However, an isolated surgical approach to the tricuspid valve continues to be rarely indicated, and there are still no data showing improved survival with TR surgical treatment alone, making this condition undertreated in clinical practice, despite the increased mortality rate in patients with moderate to severe TR clinically-only managed.

Based on these observations, the treatment of TR has recently been shifting from a conservative to a more interventional approach. This shift has led to first-in-human attempts at transcatheter tricuspid valve interventions (TTVI). Several devices have been developed, with strategies based on reducing the valve annulus, improving coaptation between the leaflets, or valve replacement. In a propensity-matched case-control study, TTVI was associated with 40% greater survival and freedom from heart failure rehospitalization.

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