Inova Study Offers New Treatment for Tricuspid Valve Regurgitation

Wayne Batchelor, MD, is Director of Interventional Cardiology and Interventional Cardiology Research at the Inova Heart and Vascular Institute. His outpatient practice is based at the Inova Cardiology Fairfax office. He is board-certified in cardiovascular disease with added qualifications in interventional cardiology.

Tricuspid valve regurgitation is a relatively common problem. Millions of Americans have the condition, which is caused by a leaky heart valve known as the tricuspid valve. But unlike problems in other valves, there have been few treatment options for faulty tricuspid valves.

That may be changing. The Inova Heart and Vascular Institute is participating in a clinical trial to test a new minimally invasive treatment for tricuspid regurgitation — a promising potential treatment that could be a major step forward in treating this disorder.

What is Tricuspid Valve Regurgitation?

The tricuspid valve is located on the right side of the heart. In a healthy heart, the valve prevents blood from leaking back into the heart’s right atrium. This causes the right side of the heart to work harder, and causes symptoms such as:

• Fatigue
• Shortness of breath
• Swelling in the legs and feet
• Kidney abnormalities
• Enlarged liver

Without treatment, tricuspid regurgitation can significantly interfere with quality of life, and eventually lead to right heart failure.

Triluminate: New Treatment for Tricuspid Regurgitation

Tricuspid regurgitation is challenging to treat. Medications can control symptoms such as swelling. The only real option to repair the leaky valve has traditionally been open-heart surgery. Unfortunately, that option is too risky for many patients with tricuspid regurgitation, who tend to be older and often have other health problems.

That’s why this study, known as the Triluminate Pivotal trial, is so promising. The study will test a new, minimally invasive procedure to repair the tricuspid valve. Using a catheter inserted into blood vessels in the groin, we maneuver special clips into the heart and place them in the valve to close the leak. 

There is a similar procedure for repairing leaks in the mitral valve. But such an option hasn’t been available for the tricuspid valve. One reason for that is that the tricuspid valve has more leaflets, or flaps, making it more challenging to place the clips. Another is that its location makes it harder to get clear images of the valve. And to place the clips in the right location, good imaging is crucial.

Thanks to new imaging techniques and new devices, we’re finally able to test a nonsurgical option for treating this disease.

Leaders in Heart Valve Disease Treatment

Inova is one of the hospitals at the forefront of the Triluminate Pivotal trial, and the only center in northern Virginia with access to this new technology. Along with other health systems across the country, we will be evaluating patients to determine whether they might be good candidates for the procedure. Those who are selected will be randomly assigned to either undergo the procedure or receive medication as usual. We hope to demonstrate that the procedure is safe and effective for treating tricuspid regurgitation. 

So far, the procedure appears to be quite safe. The Structural Heart team are experts in repairing and replacing all types of heart valves, and we’re well prepared to adapt to this new procedure. But our participation in the study wouldn’t be possible without the strong multidisciplinary team at Inova. This procedure requires experts in heart failure, imaging, cardiothoracic surgery and interventional cardiology, as well as skilled nurses, advanced practice providers and others experienced in structural heart disease. The breadth and depth of knowledge and teamwork at the Inova Heart and Vascular Institute makes it possible for us to offer this exciting new treatment.  And we’re excited to participate in a study that will help us continue to be leaders in innovation while providing the best care for patients.

Learn more about the full scope of Inova’s Structural Heart Disease Program.