Progress of transcatheter tricuspid valve replacement treatment device_West China Medical Journal

Authors：

YU Zhixiang , LI Yijian , HE Qianbei , CHAI Bofeng , LI Ruitao , Ge Runamu ,  FENG Yuan

Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

FENG Yuan, Email: fynotebook@hotmail.com

Keywords：

Tricuspid regurgitation; right heart failure; transcatheter tricuspid valve intervention; transcatheter tricuspid valve replacement

DOI：

10.7507/1002-0179.202509315

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Tricuspid regurgitation (TR) is a clinically prevalent valvular heart disease with an age-dependent increase in incidence. Patients with symptomatic severe TR are confronted with limited efficacy of medical treatment and high risks of surgical intervention. In recent years, transcatheter tricuspid valve replacement has rapidly evolved as a novel therapeutic strategy to address the challenge. This article systematically reviews the design features and clinical studies of transcatheter tricuspid valve replacement devices globally, providing valuable insights and evidence for expanding clinical approaches in the treatment of the patients with TR.

1.	Wang N, Fulcher J, Abeysuriya N, et al. Tricuspid regurgitation is associated with increased mortality independent of pulmonary pressures and right heart failure: a systematic review and meta-analysis. Eur Heart J, 2019, 40(5): 476-484.
2.	Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet, 2006, 368(9540): 1005-1011.
3.	Benfari G, Antoine C, Miller WL, et al. Excess mortality associated with functional tricuspid regurgitation complicating heart failure with reduced ejection fraction. Circulation, 2019, 140(3): 196-206.
4.	Hon JK, Cheung A, Ye J, et al. Transatrial transcatheter tricuspid valve-in-valve implantation of balloon expandable bioprosthesi. Ann Thorac Surg, 2010, 90(5): 1696-1697.
5.	Adamo M, Chioncel O, Pagnesi M, et al. Epidemiology, pathophysiology, diagnosis and management of chronic right‐sided heart failure and tricuspid regurgitation. A clinical consensus statement of the heart failure association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC. Eur J Heart Fail, 2024, 26(1): 18-33.
6.	Offen S, Playford D, Strange G, et al. Adverse prognostic impact of even mild or moderate tricuspid regurgitation: insights from the national echocardiography database of Australia. J Am Soc Echocardiogr, 2022, 35(8): 810-817.
7.	Prihadi EA, Delgado V, Leon MB, et al. Morphologic types of tricuspid regurgitation: characteristics and prognostic implications. JACC Cardiovasc Imaging, 2019, 12(3): 491-499.
8.	Hahn RT, Zamorano JL. The need for a new tricuspid regurgitation grading scheme. Eur Heart J Cardiovasc Imaging, 2017, 18(12): 1342-1343.
9.	Praz F, Borger MA, Lanz J, et al. 2025 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2025: ehaf194.
10.	Topilsky Y, Khanna AD, Oh JK, et al. Preoperative factors associated with adverse outcome after tricuspid valve replacement. Circulation, 2011, 123(18): 1929-1939.
11.	Sannino A, Ilardi F, Hahn RT, et al. Clinical and echocardiographic outcomes of transcatheter tricuspid valve interventions: a systematic review and meta-analysis. Front Cardiovasc Med, 2022, 9: 919395.
12.	Raj Makkar. TRISCEND study 2-year outcomes: transfemoral transcatheter tricuspid valve replacement. London: PCR London Valves 2023, 2023.
13.	Hahn RT, Makkar R, Thourani VH, et al. Transcatheter valve replacement in severe tricuspid regurgitation. N Engl J Med, 2025, 392(2): 115-126.
14.	Pan X, Lu F, Wang Y, et al. Transcatheter tricuspid valve replacement with the novel system: 1-year outcomes from the travel study. JACC Cardiovasc Interv, 2025, 18(10): 1276-1285.
15.	Granada JF. The LuX-Valve plus transjugular TTVR system: one-year outcomes of a multicenter clinical study in high surgical risk TR patients. Washington, DC: TCT 2024, 2024.
16.	Hahn RT, Kodali S, Fam N, et al. Early multinational experience of transcatheter tricuspid valve replacement for treating severe tricuspid regurgitation. JACC Cardiovasc Interv, 2020, 13(21): 2482-2493.
17.	Fam NP, Ong G, Estevez-Loureiro R, et al. Transcatheter tricuspid valve replacement with the cardiovalve system. JACC Cardiovasc Interv, 2024, 17(4): 586-588.
18.	Heidenreich P; ACP Journal Club Editorial Team at McMaster University. In symptomatic severe tricuspid regurgitation, adding TTVR to medical therapy improved a hierarchical composite outcome at 1 y. Ann Intern Med, 2025, 178(3): JC29.
19.	Huang L, Sun Z, Cai Y, et al. Comparison of clinical and echocardiographic outcomes between mini-thoracotomy transatrial LuX-Valve transcatheter and surgical tricuspid valve replacement. Front Cardiovasc Med, 2024, 11: 1417757.
20.	Wang Y, Liu Y, Meng X, et al. Comparing outcomes of transcatheter tricuspid valve replacement and medical therapy for symptomatic severe tricuspid regurgitation: a retrospective study. Eur J Med Res, 2024, 29(1): 407.
21.	孙艳丹, 曹亮, 白炜, 等. 经导管三尖瓣置换装置 Lux-Valve 与 Lux-valve plus 治疗重度三尖瓣反流患者的疗效比较. 浙江大学学报 (医学版), 2025, 54(2): 213-218.
22.	Azami P, Hosseinpour A, Kamalpour J, et al. Efficacy and safety of transcatheter tricuspid valve replacement in patients with moderate to severe tricuspid regurgitation: a systematic review and meta‐analysis on clinical outcomes and echocardiographic indices. Health Sci Rep, 2025, 8(6): e70950.
23.	Hausleiter J, Stolz L, Lurz P, et al. Transcatheter tricuspid valve replacement. J Am Coll Cardiol, 2025, 85(3): 265-291.
24.	Kodali S, Hahn RT, Makkar R, et al. Transfemoral tricuspid valve replacement and one-year outcomes: the TRISCEND study. Eur Heart J, 2023, 44(46): 4862-4873.
25.	Scotti A, Puri R, Sturla M, et al. Incidence, predictors, and management of conduction disturbances after transcatheter tricuspid valve replacement. JACC Cardiovasc Interv, 2025, 18(14): 1789-1799.
26.	Lauten A, Ferrari M, Hekmat K, et al. Heterotopic transcatheter tricuspid valve implantation: First-in-man application of a novel approach to tricuspid regurgitation. Eur Heart J, 2011, 32(10): 1207-1213.
27.	Estévez-Loureiro R, Sánchez-Recalde A, Amat-Santos IJ, et al. 6-month outcomes of the TricValve system in patients with tricuspid regurgitation: the TRICUS EURO study. JACC Cardiovasc Interv, 2022, 15(13): 1366-1377.
28.	Lurz P, Kresoja KP, Besler C, et al. Heterotopic crosscaval transcatheter tricuspid valve replacement for patients with tricuspid regurgitation: the trillium device. JACC Cardiovasc Interv, 2025, 18(11): 1425-1434.
29.	Wild MG, Lubos E, Cruz-Gonzalez I, et al. Early clinical experience with the TRICENTO bicaval valved stent for treatment of symptomatic severe tricuspid regurgitation: a multicenter registry. Circ Cardiovasc Interv, 2022, 15(3): e011302.
30.	Blasco-Turrión S, Briedis K, Estévez-Loureiro R, et al. Bicaval TricValve implantation in patients with severe symptomatic tricuspid regurgitation: 1-year follow-up outcomes. JACC Cardiovasc Interv, 2024, 17(1): 60-72.
31.	McElhinney DB, Aboulhosn JA, Dvir D, et al. Mid-term valve-related outcomes after transcatheter tricuspid valve-in-valve or valve-in-ring replacement. J Am Coll Cardiol, 2019, 73(2): 148-157.
32.	Van Garsse LA, ter Bekke RM, van Ommen VG. Percutaneous transcatheter valve-in-valve implantation in stenosed tricuspid valve bioprosthesis. Circulation, 2011, 123(5): e219-e221.
33.	Schamroth Pravda N, Vaknin Assa H, Levi A, et al. Tricuspid structural valve deterioration treated with a transcatheter valve-in-valve implantation: a single-center prospective registry. J Clin Med, 2022, 11(9): 2667.
34.	McElhinney DB, Cabalka AK, Aboulhosn JA, et al. Transcatheter tricuspid valve-in-valve implantation for the treatment of dysfunctional surgical bioprosthetic valves: an international, multicenter registry study. Circulation, 2016, 133(16): 1582-1593.
35.	Montenegro da Costa MJ, Quintella EF, Kohn L, et al. Transcatheter tricuspid valve-in-valve procedure-an illustrative case report and review. J Clin Med, 2021, 10(17): 4004.
36.	Aboulhosn J, Cabalka AK, Levi DS, et al. Transcatheter valve-in-ring implantation for the treatment of residual or recurrent tricuspid valve dysfunction after prior surgical repair. JACC Cardiovasc Interv, 2017, 10(1): 53-63.

1. Wang N, Fulcher J, Abeysuriya N, et al. Tricuspid regurgitation is associated with increased mortality independent of pulmonary pressures and right heart failure: a systematic review and meta-analysis. Eur Heart J, 2019, 40(5): 476-484.
2. Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet, 2006, 368(9540): 1005-1011.
3. Benfari G, Antoine C, Miller WL, et al. Excess mortality associated with functional tricuspid regurgitation complicating heart failure with reduced ejection fraction. Circulation, 2019, 140(3): 196-206.
4. Hon JK, Cheung A, Ye J, et al. Transatrial transcatheter tricuspid valve-in-valve implantation of balloon expandable bioprosthesi. Ann Thorac Surg, 2010, 90(5): 1696-1697.
5. Adamo M, Chioncel O, Pagnesi M, et al. Epidemiology, pathophysiology, diagnosis and management of chronic right‐sided heart failure and tricuspid regurgitation. A clinical consensus statement of the heart failure association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC. Eur J Heart Fail, 2024, 26(1): 18-33.
6. Offen S, Playford D, Strange G, et al. Adverse prognostic impact of even mild or moderate tricuspid regurgitation: insights from the national echocardiography database of Australia. J Am Soc Echocardiogr, 2022, 35(8): 810-817.
7. Prihadi EA, Delgado V, Leon MB, et al. Morphologic types of tricuspid regurgitation: characteristics and prognostic implications. JACC Cardiovasc Imaging, 2019, 12(3): 491-499.
8. Hahn RT, Zamorano JL. The need for a new tricuspid regurgitation grading scheme. Eur Heart J Cardiovasc Imaging, 2017, 18(12): 1342-1343.
9. Praz F, Borger MA, Lanz J, et al. 2025 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2025: ehaf194.
10. Topilsky Y, Khanna AD, Oh JK, et al. Preoperative factors associated with adverse outcome after tricuspid valve replacement. Circulation, 2011, 123(18): 1929-1939.
11. Sannino A, Ilardi F, Hahn RT, et al. Clinical and echocardiographic outcomes of transcatheter tricuspid valve interventions: a systematic review and meta-analysis. Front Cardiovasc Med, 2022, 9: 919395.
12. Raj Makkar. TRISCEND study 2-year outcomes: transfemoral transcatheter tricuspid valve replacement. London: PCR London Valves 2023, 2023.
13. Hahn RT, Makkar R, Thourani VH, et al. Transcatheter valve replacement in severe tricuspid regurgitation. N Engl J Med, 2025, 392(2): 115-126.
14. Pan X, Lu F, Wang Y, et al. Transcatheter tricuspid valve replacement with the novel system: 1-year outcomes from the travel study. JACC Cardiovasc Interv, 2025, 18(10): 1276-1285.
15. Granada JF. The LuX-Valve plus transjugular TTVR system: one-year outcomes of a multicenter clinical study in high surgical risk TR patients. Washington, DC: TCT 2024, 2024.
16. Hahn RT, Kodali S, Fam N, et al. Early multinational experience of transcatheter tricuspid valve replacement for treating severe tricuspid regurgitation. JACC Cardiovasc Interv, 2020, 13(21): 2482-2493.
17. Fam NP, Ong G, Estevez-Loureiro R, et al. Transcatheter tricuspid valve replacement with the cardiovalve system. JACC Cardiovasc Interv, 2024, 17(4): 586-588.
18. Heidenreich P; ACP Journal Club Editorial Team at McMaster University. In symptomatic severe tricuspid regurgitation, adding TTVR to medical therapy improved a hierarchical composite outcome at 1 y. Ann Intern Med, 2025, 178(3): JC29.
19. Huang L, Sun Z, Cai Y, et al. Comparison of clinical and echocardiographic outcomes between mini-thoracotomy transatrial LuX-Valve transcatheter and surgical tricuspid valve replacement. Front Cardiovasc Med, 2024, 11: 1417757.
20. Wang Y, Liu Y, Meng X, et al. Comparing outcomes of transcatheter tricuspid valve replacement and medical therapy for symptomatic severe tricuspid regurgitation: a retrospective study. Eur J Med Res, 2024, 29(1): 407.
21. 孙艳丹, 曹亮, 白炜, 等. 经导管三尖瓣置换装置 Lux-Valve 与 Lux-valve plus 治疗重度三尖瓣反流患者的疗效比较. 浙江大学学报 (医学版), 2025, 54(2): 213-218.
22. Azami P, Hosseinpour A, Kamalpour J, et al. Efficacy and safety of transcatheter tricuspid valve replacement in patients with moderate to severe tricuspid regurgitation: a systematic review and meta‐analysis on clinical outcomes and echocardiographic indices. Health Sci Rep, 2025, 8(6): e70950.
23. Hausleiter J, Stolz L, Lurz P, et al. Transcatheter tricuspid valve replacement. J Am Coll Cardiol, 2025, 85(3): 265-291.
24. Kodali S, Hahn RT, Makkar R, et al. Transfemoral tricuspid valve replacement and one-year outcomes: the TRISCEND study. Eur Heart J, 2023, 44(46): 4862-4873.
25. Scotti A, Puri R, Sturla M, et al. Incidence, predictors, and management of conduction disturbances after transcatheter tricuspid valve replacement. JACC Cardiovasc Interv, 2025, 18(14): 1789-1799.
26. Lauten A, Ferrari M, Hekmat K, et al. Heterotopic transcatheter tricuspid valve implantation: First-in-man application of a novel approach to tricuspid regurgitation. Eur Heart J, 2011, 32(10): 1207-1213.
27. Estévez-Loureiro R, Sánchez-Recalde A, Amat-Santos IJ, et al. 6-month outcomes of the TricValve system in patients with tricuspid regurgitation: the TRICUS EURO study. JACC Cardiovasc Interv, 2022, 15(13): 1366-1377.
28. Lurz P, Kresoja KP, Besler C, et al. Heterotopic crosscaval transcatheter tricuspid valve replacement for patients with tricuspid regurgitation: the trillium device. JACC Cardiovasc Interv, 2025, 18(11): 1425-1434.
29. Wild MG, Lubos E, Cruz-Gonzalez I, et al. Early clinical experience with the TRICENTO bicaval valved stent for treatment of symptomatic severe tricuspid regurgitation: a multicenter registry. Circ Cardiovasc Interv, 2022, 15(3): e011302.
30. Blasco-Turrión S, Briedis K, Estévez-Loureiro R, et al. Bicaval TricValve implantation in patients with severe symptomatic tricuspid regurgitation: 1-year follow-up outcomes. JACC Cardiovasc Interv, 2024, 17(1): 60-72.
31. McElhinney DB, Aboulhosn JA, Dvir D, et al. Mid-term valve-related outcomes after transcatheter tricuspid valve-in-valve or valve-in-ring replacement. J Am Coll Cardiol, 2019, 73(2): 148-157.
32. Van Garsse LA, ter Bekke RM, van Ommen VG. Percutaneous transcatheter valve-in-valve implantation in stenosed tricuspid valve bioprosthesis. Circulation, 2011, 123(5): e219-e221.
33. Schamroth Pravda N, Vaknin Assa H, Levi A, et al. Tricuspid structural valve deterioration treated with a transcatheter valve-in-valve implantation: a single-center prospective registry. J Clin Med, 2022, 11(9): 2667.
34. McElhinney DB, Cabalka AK, Aboulhosn JA, et al. Transcatheter tricuspid valve-in-valve implantation for the treatment of dysfunctional surgical bioprosthetic valves: an international, multicenter registry study. Circulation, 2016, 133(16): 1582-1593.
35. Montenegro da Costa MJ, Quintella EF, Kohn L, et al. Transcatheter tricuspid valve-in-valve procedure-an illustrative case report and review. J Clin Med, 2021, 10(17): 4004.
36. Aboulhosn J, Cabalka AK, Levi DS, et al. Transcatheter valve-in-ring implantation for the treatment of residual or recurrent tricuspid valve dysfunction after prior surgical repair. JACC Cardiovasc Interv, 2017, 10(1): 53-63.

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