UNICA − a novel single-stent, double-valve, heterotopic, cross-caval approach for severe tricuspid insufficiency

We present an 85-year-old female patient in New York Heart Association (NYHA) Functional Class III, with preserved left ventricular ejection fraction, who experienced recurrent valvular heart failure hospitalisations and cardiac decompensation due to severe, torrential tricuspid regurgitation (TR) with a large coaptation defect (grade 5/5, 16 mm gap) (Figure 1A, Moving image 1). She also exhibited typical flow reversal in the liver veins, recurrent pleural effusion, and severe peripheral oedema. Due to her advanced age, clinical condition, complex anatomy, and comorbidities, which resulted in a calculated Society of Thoracic Surgeons (STS) short-term risk score of 13% and a TRI-SCORE of 5/12 with a predicted in-hospital ...