Transcatheter Tricuspid Valve Repair: First-in-Man Implantation of TriCinch Device

23 November 2015

TriCinch (4Tech Cardio) TV repair device is evaluated in humans in a prospective trial.

Transcatheter Tricuspid Valve Repair: First-in-Man Implantation of TriCinch Device

The case report of Dr. Azeem Latib et al was published in the JACC: Cardiovascular Interventions (Vol. 8, No. 13, 2015).
The design concept of the TriCinch system was initially based on mimicking the Kay procedure by cinching at the anteroposterior commissure and reducing septolateral dimensions. 

The “first-in-man” patient was a 72-year-old woman with severe functional TR associated with tricuspid annular dilation. She was admitted in New York Heart Association functional class III after 2 episodes of decompensated heart failure in the previous 2 months, presenting with edema of the lower extremities, moderate ascites, jugular venous distension, with moderate liver dysfunction due to hepatitis C (unconjugated bilirubin 2.7 mg/dl) and normal kidney function (creatinine 1 mg/dl, glomerular filtration rate 57.8 ml/min). She had a clinical history of permanent atrial fibrillation and prior aortic valve replacement with abioprosthesis.

After multidisciplinary heart team agreement on the transcatheter TV repair option with the TriCinch System, the patient was enrolled in the PREVENT (Percutaneous Treatment of Tricuspid Valve Regurgitation With the TriCinch System; NCT02098200) study.

This first-in-man case demonstrates the feasibility and safety of the percutaneous remodeling of the TV by implanting the TriCinch device, associated with reduction in annular dimensions and TR severity. Although the device only resulted in a modest reduction in TR, this may be sufficient for symptomatic improvement in these patients in whom elimination of TR may be harmful.

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