Innovative Catheter Technology Repairs Leaky Tricuspid Valve

An implantable annuloplasty band for treating mitral regurgitation (MR) has been used for the first time to repair a leaky tricuspid valve.

The Cardioband system offers a minimally invasive alternative to open heart surgery by combining a reconstruction implant with a transfemoral, transseptal catheter delivery system. The band itself has three elements: a polyester fabric sleeve, stainless steel anchors, and an adjustment mechanism inside the sleeve that allows homogeneous circumferential cinching after full deployment of the implant. The segmental deployment technique for affixing the band to the tissue ensures that Cardioband conforms to each patient’s specific annular geometry.

The Cardioband, which is available in six sizes, is connected to the posterior annulus, trigone to trigone, via the specially designed spiral anchors that worm their way into the tissue. Once the band has been secured with the anchors to the circumference of the annulus, it is reshaped under echocardiographic guidance using the adjustment mechanism, providing real-time fine-tuning on the beating heart itself, until the valve closes fully again. The Cardioband system is a product of Valtech Cardio (Or Yehuda, Israel), and has received the Conformite Europeenne (CE) mark of approval.

“As tricuspid insufficiency often arises as a consequence of diseases of the mitral valve, open heart procedures are a risky surgical intervention,” said Professor Francesco Maisano, MD, of The University Hospital of Zurich (Switzerland), who placed the first Cardioband on the tricuspid valve. “The Cardioband is a minimally invasive therapy which does not require the use of a heart-lung machine, reducing the impact on the patient and lowering the risk. Now, even patients previously thought to be inoperable can be treated.”

The tricuspid valve separates the right atrium of the heart from the right ventricle, preventing blood from flowing back into the atrium. Diseases of the tricuspid valve are much more rare than those of the mitral valve, its counterpart in the left half of the heart. A tricuspid insufficiency, where the valve fails to work properly, can lead to serious symptoms. The build-up of blood in the ventricle and the veins causes increased pressure on these organs, resulting in water retention in the legs and abdomen, liver damage, and potential atrial fibrillation (AF). Until now, the only treatment option for a leaky tricuspid valve was open-heart surgery using a heart-lung machine.

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