Novel Transcatheter Tricuspid Valve Replacement Device for Recurrent Regurgitation After Failed Surgical Repair.

BACKGROUND: Recurrent tricuspid regurgitation (TR) after surgical annuloplasty is a common challenge, and redo surgery carries high risk. Transcatheter valve-in-ring approaches are often limited by paravalvular leak (PVL), especially with incomplete bands. FIRST-IN-HUMAN/EARLY REPORTS SUMMARY: The novel transcatheter tricuspid valve replacement (TTVR) system TOPAZ (TRiCares) offers a therapeutic option for high-risk patients with severe TR. DISCUSSION: The TOPAZ dual-stent design includes a conformable outer frame that may improve annular sealing, reduce paravalvular leak, limit patient-prosthesis mismatch, and minimize right ventricular interaction. NOVELTY: This case describes the first-in-human use of TOPAZ TTVR to treat recurrent TR in a failed incomplete surgical annuloplasty band. TAKE-HOME MESSAGES: TOPAZ TTVR is feasible in failed annuloplasty rings/bands. Its conformable design may reduce paravalvular leak and provide a treatment alternative to patients with large surgical rings/bands.