Canadian cardiologists perform world’s 1st minimally invasive tricuspid valve replacement

Physicians at St. Michael’s Hospital of Unity Health Toronto in Canada announced this month that they’d completed the world’s first minimally invasive tricuspid valve replacement with success.

The patient in question, a 76-year-old man, presented to St. Michael’s with enough damage that low-effort tasks like getting out of a car or walking from the bedroom to the bathroom were difficult. Within 48 hours of his valve replacement procedure, performed with Edwards Lifesciences' EVOQUE tricuspid valve replacement system, doctors Neil Fam, Mark Peterson and Geraldine Ong reported he was doing significantly better and was able to resume those daily tasks.

The EVOQUE valve was developed and first used for mitral valve replacement, but, according to a release from St. Michael’s, Fam approached Edwards two years ago about using the valve system for tricuspid replacements. Tricuspid valve replacements are typically performed via open heart surgery or thoracotomy, but both of those options are invasive, heightening procedural risk for older patients.

“Doing tricuspid valve replacements through the femoral approach is a game-changer as it opens up treatment options for patients with heart failure who are too sick to undergo surgery or are not good candidates for tricuspid clipping,” Fam, the director of Interventional Cardiology and Cardiac Catheterization Labs at St. Michael’s, said in the release. “Going through the femoral vein means the risk of complications is dramatically lower.”

The structural heart team at St. Michael’s has reportedly performed multiple tricuspid valve procedures since its first success with the EVOQUE system, which took place back in May of 2019. Cardiologists on staff also perform tricuspid valve interventions using the  MitraClip and PASCAL repair systems.

Fam et al. said their early results are encouraging—but they’re preliminary. Further studies are planned.