Transcatheter tricuspid valve replacement (TTVR) with the LuX-Valve system led to a sustains reduction in tricuspid regurgitation (TR) over 1 year in the TRAVEL study. The findings were published Monday online ahead of print in the JACC: Cardiovascular Interventions, with authors led by Xiangbin Pan, MD, PhD, from the Chinese Academy of Medical Science and Peking Union Medical College, Fanglin Lu, MD, PhD, from Shanghai Jiaotong University, and Yiwei Wang, MD PhD, from Air Force Medical University, China. The authors marked TTVR as a "promising surgical alternative for high-risk patients with tricuspid regurgitation," noting that the current guideline-recommended treatment option — surgery — has "limited" evidence with historically "poor" outcomes, while optimal medical therapy (OMT) has failed to halt the disease's natural progression. "According to studies, the 1-year mortality rate in this patient population exceeds 40%," the researchers stressed. However, despite highlighting growing clinical experience and evidence of the safety and efficacy of transcatheter tricuspid valve intervention (TTVI) to "reduce or even eliminate TR," they stressed that "considering the complexity of the right heart structure, more dedicated devices with different technical characteristics are needed to deal with the large and heterogeneous TR population.” The current prospective, Chinese multicenter, single-arm TRAVEL study set out to evaluate the clinical performance of Jenscare Biotechnology's LuX-Valve TTVR system in 126 patients with symptomatic severe or greater TR at high risk for tricuspid valve (TV) surgery. The patients were enrolled from June 2020 to August 2021, and all underwent TTVR via the transatrial approach using the LuX-Valve system. At baseline, the mean age was 65.8 years, the majority (79.4%) were women and all patients were in New York Heart Associated (NYHA) functional class III or IV, with 14.3% graded as torrential, 34.9% massive and 50.8% severe. The mean Society of Thoracic Surgeons score was 9.2 and mean left ventricular ejection fraction was 59.9%. The majority (68.3%) had histories of left-sided valve surgery, atrial fibrillation (72.2%) and hospitalization for heart failure in the last year (44.4%). The 1-year primary endpoints of all-cause mortality and hospitalization for heart failure occurred in 10.3% and 4% of patients respectively. TR was reduced to mild or less in 95.2% of patients (P < 0.001), with "significantly positive right heart reverse remodeling" measured by decreases in right atrial systolic volume (-38.3 ± 21.7 mL; P < 0.001) and mid right ventricular end-systolic diameter (6.4 ± 2.3 mm; P < 0.001). NYHA functional class I or II was achieved in 79.8% (P < 0.001), and 6-minute walking distance increased by 71.3 ± 42.8 m (P < 0.001). There were no intraoperative deaths or occurrences of third-degree atrioventricular block, right coronary injury, or other major intraoperative complications, the researchers added. New-onset permanent pacemaker implantation was required in 2 patients (1.6%), and 3 patients experienced in-hospital mortality. The researchers marked a "heightened risk for bleeding complications" — procedure-related access site bleeding occurred in 16 patients (12.7%) — however, they stressed that the "markedly lower mortality and heart failure hospitalization rates, coupled with substantial improvements in clinical functional status, suggest that the LuX-Valve may offer an acceptable treatment option for high-risk patients with TR who have limited alternative therapeutic options.” They called for longer-term follow-up and further randomized controlled trials to validate survival benefits with use of the device. In an accompanying editorial, Neil P. Fam, MD, MSc, and Sami Alnasser, MD, from the University of Toronto, Canada, said, "Expansion of the TTVR size matrix and design diversity should be very exciting to the field." They added that, "Because tricuspid valve anatomy and related TR mechanisms are highly variable, ongoing innovation is essential to enable the treatment of more patients in need of tricuspid valve intervention. "Patient and device selection continues to evolve and will be informed by the results of ongoing clinical trials." Sources: Pan X, Lu F, Wang Y, et al. Transcatheter Tricuspid Valve Replacement With the Novel System: 1-Year Outcomes From the TRAVEL Study. JACC Cardiovasc Interv 2025; DOI: 10.1016/j.jcin.2024.12.030. Fam N, Alnasser S. The Evolving Landscape of TTVR: Embracing the LuXury of Choice. JACC Cardiovasc Interv 2025; DOI: 10.1016/j.jcin.2024.07.048. Image Credit: Adobe – stock.adobe.com