A novel tricuspid flow optimiser for severe tricuspid regurgitation (TRiFlO)

Severe tricuspid regurgitation (TR), leading to a cascade of pathophysiological changes, significantly impacts quality of life, increases hospitalisation rates, and reduces survival if left untreated1. Increased systemic venous congestion from volume overload reduces cardiac output, leading to right-sided heart failure. This also causes right ventricle (RV) dilation and dysfunction, exacerbating ventricular interdependence and resulting in systolic and diastolic dysfunction of the left ventricle (LV) along with pulmonary congestion. These effects can lead to irreversible multiorgan damage, highlighting the importance of timely intervention12.

Current medical therapies primarily focus on alleviating systemic congestion, providing only palliative effects. This highlights the need for more effective interventional therapies that address the underlying structural issues of the tricuspid valve (TV) and right heart chambers. Given the complex anatomy of the TV and the intricate pathophysiology of RV dysfunction, selecting the appropriate patient and device for intervention is challenging23. The ideal transcatheter TV device should not only restore physiological TV function through laminar flow but also minimise interaction with the RV and native TV leaflets, accommodate anatomical variations, and promote positive RV...