First-in-Man Implantation of a Tricuspid Annular Remodeling Device for Functional Tricuspid Regurgitation.

T ricuspid regurgitation (TR) is a common finding in patients with left-sided disease, and is associated with poor outcome and predicts poor survival, heart failure, and reduced functional capacity (1). It is common after mitral valve treatment in rheumatic or ischemic mitral regurgitation, if left untreated at the time of mitral surgery. In this subgroup with long-standing TR, managed medically for a long time, surgical correction can be more prohibitive due to the presence of variable degrees of right ventricular (RV) dysfunction, pulmonary vascular disease, and right heart failure. The pre-operative condition of the RV and the severity of secondary renal and hepatic impairment are predictors of limited survival (2,3). Percutaneous procedures may be an attractive alternative to surgery for patients deemed to be high-risk surgical candidates. While the development and clinical use of percutaneous approaches to the aortic valve and mitral valve have been widespread over the past few years, limited data are available about the feasibility and efficacy of percutaneous tricuspid valve (TV) therapies (4,5).