UPMC Heart and Vascular Institute in Central Pa. Team Performs First TricValve Case

Experts at the UPMC Heart and Vascular Institute in Central Pa. recently performed their first TricValve case to treat a patient with tricuspid regurgitation. UPMC is amongst the first centers in the country to use this groundbreaking therapy.

Hemal Gada, MD, president of the UPMC Heart and Vascular Institute in Central Pa., is a principal investigator on an innovative trial testing the TricValve® Transcatheter Bicaval Valves System at UPMC Harrisburg.

The purpose of this study is to evaluate the safety and effectiveness of the TricValve® Transcatheter Bicaval Valves System for improving outcomes in patients who have symptomatic, severe tricuspid regurgitation and are considered high risk for tricuspid valve surgery.

The TricValve system consists of two self-expanding biological valves which are implanted percutaneously into the superior and inferior vena cava without disturbing the native tricuspid valve.

To be eligible for the trial, patients must be 18 years or older with severe tricuspid regurgitation as evidenced on transthoracic echocardiogram (TTE) and be willing to provide signed, informed consent. Patients must also be NYHA Class III-IVa or have a recent heart failure admission and must have been optimized on medical therapy for heart failure.

With tricuspid regurgitation, the tricuspid valve does not close properly, allowing blood to flow backwards into the right side of the heart. This leads to congestion and decreased quality of life over time. 

Individuals often can tolerate tricuspid regurgitation for long periods of time without experiencing worsening symptoms. Patients generally only present when tricuspid regurgitation is severe, and the right side of the heart, including the tricuspid valve annulus, dilates to accommodate the increased blood and pressure buildup. If the valve anatomy is too dilated, the patient may not qualify for other trials and therapies that rely on the tricuspid valve anatomy.

“This trial is unique as it does not rely on the valve anatomy and provides a treatment option for high-risk patients,” says Hemal Gada, MD. “The procedure is minimally invasive and two stented heart valves are placed: one is placed in the Superior Vena Cava (SVC), and one is placed in the Inferior Vena Cava (IVC); therefore, these valves reduce peripheral congestion by preventing backflow into the body, thereby reducing TR.”

This treatment method presents the potential benefit of decreasing systemic congestion symptoms and caval backflow which would lead to increased cardiac output and, ultimately, improved quality of life.

The first TricValve case at UPMC was performed in October 2024 on an 81-year-old male who initially presented with worsening dyspnea with minimal exertion, significant fatigue, and bilateral lower extremity edema. The patient was considered Stage C Heart Failure, NYHA class III. On an echocardiogram, the patient presented with preserved ejection fraction (EF) with severe tricuspid regurgitation, severe annular dilation, and reduced systolic function of the right ventricle.

Doctors considered the patient high-risk for cardiothoracic surgery, deeming him ineligible for open surgery and other transcatheter tricuspid therapies.

This case represents the UPMC Heart and Vascular Institute’s continued progression towards more innovative treatment options. Our team of experts is committed to providing high-risk patients with advanced care tailored to their needs. We are excited to offer the TricValve system and expand treatment options for patients with tricuspid regurgitation.

For more information, or to refer a patient to the UPMC Heart and Vascular Institute in Central Pa., call 717-231-8555.