Minimally Invasive Solutions for Tricuspid Valve Disease

Minimally Invasive Solutions for Tricuspid Valve Disease

Tricuspid regurgitation affects approximately 1.6 million people in the United States, yet only a small fraction undergoes surgical or transcatheter intervention each year [1] [2]. The tricuspid valve is complicated to restore due 
to its complex anatomy, including three leaflets, leaflet tethering, annular dilation, and right ventricular dysfunction. 
Compared to the mitral valve, these anatomical challenges contribute to poorer procedural and clinical outcomes.
Evidence has begun to show that severe tricuspid regurgitation, when left untreated, is associated with worse survival 
outcomes; therefore, intervention for this valve has become more common [1] [3]. The tricuspid valve anatomically 
prevents backflow of blood from the right ventricle into the right atrium, allowing deoxygenated blood to be pumped 
to the lungs for gas exchange [4]. This is one of the four valves of the heart that help ensure that blood flows in the 
proper direction.

Replacing a tricuspid valve is a highly complicated procedure; however, recent innovations have enabled this once 
extensive surgery to be performed using minimally invasive approaches. The Edwards EVOQUE Tricuspid Valve 
Replacement System was recently FDA-approved, involving an artificial tricuspid valve and a catheter placement 
system [5]. The artificial valve is made from bovine pericardial tissue encompassed by a self-expanding nickel titanium frame for support. It was approved under the FDA Breakthrough Devices Program, as it can provide more 
effective treatment compared to other previously approved treatments on the market. In clinical trials, 99% of treated 
patients achieved a reduction in tricuspid regurgitation to moderate or less, compared with approximately 22% of 
patients managed with medical therapy alone in historical cohorts.
As a result of treating the severe tricuspid regurgitation, patients can receive relief from symptoms of their condition,
such as fatigue, and improve their ability to exercise within six months of the procedure [5]. Ultimately, these 
improvements translate to meaningful gains in patient quality of life.

Written by Jennifer Joanna-Joan Villeneuve, 

References.
[1] S. K. Mahboobi, “Tricuspid Valve Repair,” StatPearls [Internet]., 
https://www.ncbi.nlm.nih.gov/books/NBK559179/ (accessed Dec. 11, 2025). 
[2] C. M. Vassileva, J. Shabosky, T. Boley, S. Markwell, and S. Hazelrigg, “Tricuspid valve surgery: The past 10 
years from the nationwide inpatient sample (NIS) database,” The Journal of Thoracic and Cardiovascular Surgery, 
vol. 143, no. 5, pp. 1043–1049, May 2012. doi:10.1016/j.jtcvs.2011.07.004 
[3] M. Taramasso et al., “The growing clinical importance of secondary tricuspid regurgitation,” Journal of the 
American College of Cardiology, vol. 59, no. 8, pp. 703–710, Feb. 2012. doi:10.1016/j.jacc.2011.09.069 
[4] C. C. medical professional, “Tricuspid valve: Overview, function and anatomy,” Cleveland Clinic, 
https://my.clevelandclinic.org/health/body/21851-tricuspid-valve (accessed Dec. 11, 2025). 
[5] Center for Devices and Radiological Health, “Evoque tricuspid valve replacement system – P230013,” U.S. 
Food and Drug Administration, https://www.fda.gov/medical-devices/recently-approved-devices/edwards-evoque

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