Transcatheter edge-to-edge repair (TEER), a minimally invasive procedure, is made possible by a new medical device called the Abbott TriClip™ system.

UC Davis Medical Center was one of the first facilities in the nation to have commercial access to TriClip, and the first hospital in the Western United States to utilize the system since it was approved by the U.S. Food and Drug Administration (FDA) last week. The University of California, Davis also hosted a clinical trial of the procedure in 2023.

“This procedure provides a meaningful improvement in quality of life without the high surgical risks associated with tricuspid valve surgery,” said Gagan D. Singh, the surgeon who performed the first surgery and an associate professor of cardiovascular medicine. We are excited to bring this new treatment to patients.” At the University of California, Davis Medical Center.

Tricuspid regurgitation is a disease in which the tricuspid valve of the heart does not close completely. This causes blood to leak back into the atria from the tricuspid valve, making it difficult for the patient’s heart to pump blood through the valve.

Tricuspid regurgitation affects an estimated 1.6 million Americans. Symptoms include vigorous pulsation in the neck veins, enlarged liver, and general fatigue and swelling.

Current nonsurgical treatments include diuretics (drugs that help remove excess fluid and salt) and drugs aimed at relieving symptoms. If left untreated, tricuspid regurgitation can lead to atrial fibrillation, heart failure, kidney disease, and even death.

“Severe tricuspid regurgitation is a debilitating condition with significant morbidity,” said Jason H. Rogers, professor of cardiovascular medicine. “Patients with tricuspid regurgitation are at very high risk for any surgical intervention, so until now they have only been treated with observation and diuretics.”

Tricuspid transcatheter end-to-end repair procedure

The human heart has four valves, and if any of them leak, there is no universal way to repair them. For example, the mitral valve can be repaired with a catheter-based system. However, the same catheter cannot be used for the tricuspid valve because of the location, thinness, and variability of the valve.

The new system is specifically designed to accommodate the position, location, and shape of the tricuspid valve. The patient is under general anesthesia, guided by X-rays and ultrasound, and the device is delivered through the groin and through a catheter to the heart. Once in place, the clip holds portions of the leaflets (valve flaps) together to improve the seal and reduce leakage.

The device was tested for safety and clinical efficacy as part of the TRILUMINATE Pivotal trial. UC Davis Health had one of the highest enrollment rates in the national trial.

“This minimally invasive approach allows the heart to pump blood more efficiently and reduces the symptoms of tricuspid regurgitation,” said Rogers, who plans to perform an additional tricuspid TEER procedure.

The leader in transcatheter edge-to-edge repair

UC Davis Health has been a leader in transcatheter end-to-end repair for nearly 20 years. In addition to transcatheter tricuspid valve repair procedures, the medical center’s cardiac services offer several minimally invasive catheter-based mitral valve repair procedures.

“Being one of the first centers in the country to offer commercial availability of the TriClip system is a true honor and a testament to UC Davis Health’s exceptional team-based approach to patient care,” added Singh. Ta. “The University of California, Davis Structural Heart Team is one of the best and most comprehensive in the nation. Our mission to provide complete, efficient, and high-quality care to the patients we care for , is the driving force behind our leadership in this field.”