A Novel Transcatheter Tricuspid Valve Repair System: The TriCinch Approach

Tricuspid regurgitation (TR) is a frequent finding in elderly patients, due to annular dilatation and leaflet tethering as response to right ventricular remodeling. It is common after mitral valve treatment in rheumatic or ischemic mitral regurgitation, if left untreated at the time of mitral surgery. Novel transcatheter therapies are emerging for the treatment of significant TR such patients.

The TriCinch system (4Tech Cardio Ltd, Galway, Ireland) is a percutaneous device developed for TV remodeling. It comprises of two components: 1) A transfemoral corkscrew implant, to be placed in the anterior annulus of the TV, close to the antero-posterior commissure (APC); 2) A self-expanding stent deployed in the inferior vena cava (IVC). Once the corkscrew is implanted, the system is tensioned by means of pulling and the applied remodeling is maintained by deploying the stent -connected to the corkscrew- in the IVC.

The first in human feasibility trial (PREVENT study) is actually ongoing in several European sites and the experience is expanding with more than 12 procedures performed overall. Procedural refinements and patient selection are currently improving, to target the proper TR population and to consider tricuspid valve repair also in combination of other percutaneous solutions (eg. mitral valve repair or left atrial appendage occlusion).

The PREVENT study is demonstrating the feasibility of percutaneous tricuspid valve treatment with the TriCinch device, suggesting good clinical outcome with encouraging quality of life improvement.